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Comparison of the prognostic values of three calculation methods for echocardiographic relative wall thickness in acute decompensated heart failure.


ABSTRACT:

Purpose

Left ventricular (LV) wall thickness can be measured at the posterior wall (PW) and the intraventricular septum (IVS) in a parasternal long axis view by transthoracic echocardiography. Thus, there are three methods to calculate relative wall thickness as follows: RWTPW = 2 × PWth/LVDd; RWTIVS + PW = (IVSth + PWth) /LVDd; and RWTIVS = 2 × IVSth/LVDd (IVSth = interventricular septum thickness; LVDd = LV internal dimension at end--diastole; PWth = posterior wall thickness). The aim was to compare the prognostic values of these RWTs in patients with acute decompensated heart failure (ADHF).

Method

This was a single-center, retrospective, observational study at a Japanese community hospital. A total of 389 hospitalized ADHF patients were divided into two groups based on the three median RWT values. The primary outcome was all-cause death. Survival analysis was performed, and Cox proportional hazard models unadjusted and adjusted by Get With The Guideline score were used.

Results

High-RWTPW had poor survival (log-rank, P = 0.009) and was a significant risk (unadjusted HR (95%CI), 1.72 (1.14-2.61), P = 0.01; adjusted HR, 1.95 (1.28-2.98), P = 0.02). High-RWTIVS + PW was not associated with poor survival on survival analysis or the unadjusted Cox model. Only the adjusted Cox model showed that High-RWTIVS + PW was associated with a significant risk of the primary outcome (unadjusted HR (95%CI), 1.45 (0.96-2.17), P = 0.07; adjusted HR, 1.53 (1.01-2.32), P = 0.045). High-RWTIVS did not have significant prognostic value.

Conclusions

When calculating RWT, RWTPW should be recommended for evaluating the mortality risk in ADHF.

SUBMITTER: Yamaguchi S 

PROVIDER: S-EPMC6891973 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Comparison of the prognostic values of three calculation methods for echocardiographic relative wall thickness in acute decompensated heart failure.

Yamaguchi Satoshi S   Shimabukuro Michio M   Abe Masami M   Arakaki Tomohiro T   Arasaki Osamu O   Ueda Shinichiro S  

Cardiovascular ultrasound 20191203 1


<h4>Purpose</h4>Left ventricular (LV) wall thickness can be measured at the posterior wall (PW) and the intraventricular septum (IVS) in a parasternal long axis view by transthoracic echocardiography. Thus, there are three methods to calculate relative wall thickness as follows: RWT<sub>PW</sub> = 2 × PWth/LVDd; RWT<sub>IVS + PW</sub> = (IVSth + PWth) /LVDd; and RWT<sub>IVS</sub> = 2 × IVSth/LVDd (IVSth = interventricular septum thickness; LVDd = LV internal dimension at end--diastole; PWth = po  ...[more]

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