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. 2009 Feb;22(2):190-7.
doi: 10.1016/j.echo.2008.11.005. Epub 2008 Dec 11.

Prognostic value of left ventricular end-systolic volume index as a predictor of heart failure hospitalization in stable coronary artery disease: data from the Heart and Soul Study

David D McManus  1 , Sanjiv J Shah, Mary Rose Fabi, Alisa Rosen, Mary A Whooley, Nelson B Schiller
Affiliations

Prognostic value of left ventricular end-systolic volume index as a predictor of heart failure hospitalization in stable coronary artery disease: data from the Heart and Soul Study

David D McManus et al. J Am Soc Echocardiogr. 2009 Feb.

Abstract

Objective: Left ventricular (LV) end-systolic volume indexed to body surface area (ESVI) is a simple yet powerful echocardiographic marker of LV remodeling that can be measured easily. The prognostic value of ESVI and its merit relative to other markers of LV remodeling in patients with coronary heart disease are unknown.

Methods: We examined the association of ESVI with hospitalization for heart failure (HF) and mortality in a prospective study of patients with coronary heart disease.

Results: Of the 989 participants, 110 (11%) were hospitalized for HF during 3.6 +/- 1.1 years of follow-up. Among participants in the highest ESVI quartile (> 25 mL/m(2)), 67 of 248 (27%) developed HF compared with 8 of 248 (3%) among those in the lowest quartile. The association between ESVI and HF hospitalization persisted after adjustment for potential confounders (hazard ratio 5.0, 95% confidence interval, 1.5-16.9; P = .01).

Conclusion: ESVI > 25 mL/m(2) is an independent predictor of hospitalization for HF in patients with stable coronary heart disease.

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Conflict of interest statement

Conflicts of Interest: None.

Figures

Figure 1
Figure 1
Adverse cardiovascular outcomes by ESVI quartile. *Combined end point = HF hospitalization or death.
Figure 2
Figure 2
LOWESS plot of the proportion of patients hospitalized with HF during follow-up according to baseline LV ESVI. LOWESS, Locally weighted, smoothed scatterplot.
Figure 3
Figure 3
Cumulative risk of HF hospitalization by quartile of ESVI. Curves were adjusted for sex, body mass index, history of HF, history of MI, medication use, measured creatinine clearance, log NT-proBNP, and echocardiographic variables (EF, LV EDVI, left atrial volume index, LV mass index, valvular regurgitation, and diastolic function). ESVI, End-systolic volume index.
Figure 4
Figure 4
ROC curves for LV ESDI, ESVI, and EF as predictors of hospitalization for HF. LV, Left ventricular.
Figure 5
Figure 5
HR plot for the risk of hospitalization for HF in ESVI ≥ 25 mL/m2 (vs ESVI < 25 mL/m2) in specified subgroups. *Cutoffs for NT-proBNP were determined by median BNP (173 pg/mL). †Only 4 patients with EF < 50% had an ESVI < 25 mL/m2, which limited the diagnostic utility of ESVI 25 mL/m2 in this subgroup. ESVI, End-systolic volume index; MI, myocardial infarction; HF, heart failure; CrCl, creatinine clearance; NT-proBNP, N-terminal pro-B-type natriuretic peptide; EF, ejection fraction.
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References

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