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Usefulness of Left Ventricular Vortex Flow Analysis for Predicting Clinical Outcomes in Patients with Chronic Heart Failure: A Quantitative Vorticity Imaging Study Using Contrast Echocardiography.

Authors
 In-Cheol Kim  ;  Geu-Ru Hong  ;  Gianni Pedrizzetti  ;  Chi Young Shim  ;  Seok-Min Kang  ;  Namsik Chung 
Citation
 ULTRASOUND IN MEDICINE AND BIOLOGY, Vol.44(9) : 1951-1959, 2018 
Journal Title
 ULTRASOUND IN MEDICINE AND BIOLOGY 
ISSN
 0301-5629 
Issue Date
2018
Keywords
Clinical outcomes ; Contrast echocardiography ; Kinetic energy fluctuation ; Vortex
Abstract
The goal of the study described here was to evaluate whether left ventricular vortex flow parameters, as assessed by contrast echocardiography, enhance prediction of major adverse cardiac events (MACE) in patients with chronic heart failure and systolic dysfunction. A total of 75 patients with contrast echocardiography and systolic dysfunction (ejection fraction ≤45%) were prospectively enrolled and underwent vortex flow analysis with particle image velocimetry using contrast echocardiography. Vortex flow parameters, including kinetic energy fluctuation (KEF), were evaluated. Patients were followed up for a primary endpoint of MACE that comprised hospital admission for cardiovascular causes and cardiac deaths. Across a median 277-d follow-up, 29 patients (38.7%) experienced MACE. Among these, the incidence of diabetes and the E/e' ratio were significantly higher in patients with MACE than in those without, whereas the hemoglobin level and ejection fraction were significantly lower. KEF was significantly lower in patients with MACE. In the multivariate analysis, higher KEF was associated with a lower risk of MACE (hazard ratio = 0.18, 95% confidence interval: 0.04-0.97, p = 0.046). The addition of KEF to a model with conventional parameters (e.g., age, diabetes, ejection fraction and the E/e' ratio) significantly improved the model's discrimination. Elevations in the quantitative left ventricular vortex flow parameter, KEF, as determined by contrast echocardiography, are associated with a lower risk of MACE and improved functional status among patients with chronic heart failure.
Full Text
https://www.sciencedirect.com/science/article/pii/S0301562918302187
DOI
10.1016/j.ultrasmedbio.2018.05.015
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Chung, Nam Sik(정남식)
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165450
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