Left ventricular isovolumetric relaxation time is a potentially new marker of short-term and long-term prognosis in patients with acute heart failure’s decompensation and mid-range ejection fraction

Abstract

Purpose: to assess the role of left ventricular (LV) isovolumic relaxation time (IVRT) as a predictor of adverse outcome in acute decompensated heart failure (ADHF) against the background of intermediate ejection fraction (EF) of the left ventricle.Materials and methods. The study included 121 patients aged 37  to 85 years (mean age 67.2±2.5 years) with ADHF against the background of LV ЕF; 78 — male, 43 are fermale. In all patients, the time between the end of blood flow in the outflow tract and the beginning of blood flow in the inflow tract was determined, i.e., LV IVRT. According to this parameter, the whole group was divided into 3 samples: with an average LV IVRT (70–100 ms — 54 patients), increased (more than 100 ms — 15 patients) — or reduced LV IVRT (less than 70 ms — 52 patients).Results. The mean LV IVRT in group 1 was 87.5±6.4 ms, in group 2–106.4±9.7 ms, in group 3–55.3±4.1 ms. Hospital mortality (HM) in the entire sample was 5.3%, long-term (24 months) (LM) — 39.6%. The obtained results were subjected to correlation analysis: HM was characterized by a connection with LV IVRT (r= –0.295, p<0.05), but the dependence was inversely proportional. For LM, the correlation coefficient with LV IVRT was 0.519, p><0.05, which is typical for an average connection strength. Conclusions: 1. The value of IVRT in patients with midrange LV EF correlated negatively with the levels of both in-hospital and long-term mortality: low numbers of IVRT statistically significantly predicted an increase in mortality from all causes, while a decrease in mortality was observed at high values of IVRT. 2. In patients who are hospitalized for ADHF against the background of mid-range LV EF, it is advisable to determine the LV IVRT to assess the immediate and long-term prognosis of the disease. Keywords: heart failure, acute decompensation, time of isovolumetric relaxation of the left ventricle, prognosis> ˂ 0.05), but the dependence was inversely proportional. For LM, the correlation coefficient with LV IVRT was 0.519, p ˂ 0.05, which is typical for an average connection strength.Conclusions: 1. The value of IVRT in patients with midrange LV EF correlated negatively with the levels of both in-hospital and long-term mortality: low numbers of IVRT statistically significantly predicted an increase in mortality from all causes, while a decrease in mortality was observed at high values of IVRT. 2. In patients who are hospitalized for ADHF against the background of mid-range LV EF, it is advisable to determine the LV IVRT to assess the immediate and long-term prognosis of the disease.