© 2008 European Society of Cardiology
Prognostic importance of a short deceleration time in symptomatic congestive heart failure
a The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
b Department of Cardiology, Copenhagen University Hospital, Gentofte Hospital Copenhagen, Denmark
* Corresponding author. The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej, DK 2100 Copenhagen Ø, Denmark. E-mail address: jem{at}dadlnet.dk (J.E. Møller).
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Abstract |
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Aims: A restrictive transmitral filling (RF) pattern predicts increased mortality in heart failure (HF) with reduced left ventricular (LV) systolic function. We performed a combined evaluation of LV function and RF for prognosis in patients with HF with and without systolic dysfunction.
Methods and results: Doppler echocardiography was performed in 972 patients with symptomatic HF. RF was considered present when deceleration time (DT) was 
140 ms and non-RF when > 140 ms. A DT >240 ms was defined as delayed relaxation. During a median of 51 months the unadjusted all-cause mortality rates were significantly increased among patients with RF vs. the non-RF group (1- and 4-year mortality was 25% and 54% vs. 17% and 43%). In a multivariable model, RF was a significant predictor of all-cause mortality (hazard ratio (HR)=2.0, 95% confidence interval (CI):1.5–2.6) whereas delayed relaxation was without prognostic importance (HR=0.9, CI:0.5–1.6). Repeating the multivariable model in subgroups of wall motion index (WMI) showed that RF was a strong predictor of mortality independent of WMI. For patients with LVEF of at least 50%, HR for RF was 2.0 (CI:1.1–3.4; p=0.02) and interaction between LVEF and RF was not significant.
Conclusion: In a heterogeneous population hospitalised for symptomatic HF a restrictive transmitral filling pattern, defined as shortened deceleration time, during hospitalisation is an ominous prognostic sign independent of LV systolic function.
Key Words: Heart failure • Deceleration time • Prognosis
Received January 5, 2008; Revised April 10, 2008; Accepted May 15, 2008