Clinical and prognostic implications of left ventricular dilatation in heart failure
Kasa, Gizem (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Teis, Albert (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Juncà Puig, Gladys (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Aimo, Alberto (Fondazione Toscana Gabriele Monasterio)
Lupón, Josep (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Cediel, Germán (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Santiago Vacas, Evelyn (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Codina, Pau (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Ferrer-Sistach, Elena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Vallejo Camazón, Núria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
López Ayerbe, Jorge (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bayés-Genís, Antoni (Universitat Autònoma de Barcelona. Departament de Medicina)
Delgado, Victoria (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)

Date:	2024
Abstract:	Aims To assess the agreement between left ventricular end-diastolic diameter index (LVEDDi) and volume index (LVEDVi) to define LV dilatation and to investigate the respective prognostic implications in patients with heart failure (HF). Methods Patients with HF symptoms and LV ejection fraction (LVEF) < 50% undergoing cardiac magnetic resonance were evaluated and results retrospectively. LV dilatation was defined as LVEDDi or LVEDVi above the upper normal limit according to published reference values. Patients were followed up for the combined endpoint of cardiovascular death or HF hospitalization during 5 years. A total of 564 patients (median age 64 years; 79% men) were included. LVEDDi had a modest correlation with LVEDVi (r = 0. 682, P < 0. 001). LV dilatation was noted in 84% of patients using LVEDVi-based definition and in 73% using LVEDDi-based definition, whereas 20% of patients displayed discordant definitions of LV dilatation. During a median follow-up of 2. 8 years, patients with both dilated LVEDDi and LVEDVi had the highest cumulative event rate (HR 3. 00, 95% CI 1. 15-7. 81, P = 0. 024). Both LVEDDi and LVEDVi were independently associated with the primary outcome (hazard ratio 3. 29, 95%, P < 0. 001 and 2. 8, P = 0. 009; respectively). Conclusion The majority of patients with HF and LVEF < 50% present both increased LVEDDi and LVEDVi whereas 20% show discordant linear and volumetric definitions of LV dilatation. Patients with increased LVEDDi and LVEDVi have the worst clinical outcomes suggesting that the assessment of these two metrics is needed for better risk stratification.
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Language:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Subject:	Heart failure ; Left ventricular ; Remodelling ; Dilatation ; Cardiac magnetic resonance
Published in:	European Heart Journal Cardiovascular Imaging, Vol. 25, Núm. 6 (January 2024) , p. 849-856, ISSN 2047-2412

DOI: 10.1093/ehjci/jeae025

Postprint 22 p, 514.2 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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