Journal of the American Society of Echocardiography
Volume 22, Issue 2 , Pages 190-197, February 2009

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, MD

      Affiliations

    • Division of Cardiology, University of California, San Francisco, California
    • Department of Medicine, University of California, San Francisco, California
    • D.D.M. and S.J.S. contributed equally to this work.
    • ,
  • Sanjiv J. Shah, MD

      Affiliations

    • Division of Cardiology, University of California, San Francisco, California
    • Department of Medicine, University of California, San Francisco, California
    • D.D.M. and S.J.S. contributed equally to this work.
    • ,
  • Mary Rose Fabi, MD

      Affiliations

    • Department of Medicine, Veterans Affairs Medical Center, San Francisco, California
    • ,
  • Alisa Rosen, MD

      Affiliations

    • Division of Cardiology, University of California, San Francisco, California
    • Department of Medicine, University of California, San Francisco, California
    • ,
  • Mary A. Whooley, MD

      Affiliations

    • Department of Medicine, University of California, San Francisco, California
    • Department of Medicine, Veterans Affairs Medical Center, San Francisco, California
    • ,
  • Nelson B. Schiller, MD

      Affiliations

    • Division of Cardiology, University of California, San Francisco, California
    • Department of Medicine, University of California, San Francisco, California
    • Department of Medicine, Veterans Affairs Medical Center, San Francisco, California
    • Corresponding Author InformationReprint requests: Nelson B. Schiller, MD, Division of Cardiology, Department of Medicine, University of California, San Francisco, 505 Parnassus Ave., San Francisco, CA 94143

published online 12 December 2008.

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/m2), 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/m2 is an independent predictor of hospitalization for HF in patients with stable coronary heart disease.

Keywords: Coronary artery disease, End-systolic volume index, Heart failure hospitalization, Left ventricular remodeling

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 Conflicts of Interest: None.

 Financial Disclosures: The Heart and Soul Study was supported by grants from the Department of Veterans Affairs (Epidemiology Program), Robert Wood Johnson Foundation, American Federation for Aging Research, and National Institutes of Health (R01 HL079235). Dr Shah was supported by a Heart Failure Society of America Research Fellowship Award.

PII: S0894-7317(08)00663-9

doi:10.1016/j.echo.2008.11.005

Journal of the American Society of Echocardiography
Volume 22, Issue 2 , Pages 190-197, February 2009

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