Casting Light on Early Heart Failure: Unveiling the Prognostic Potential of the E/(e' × s') Index

• Published in: Diagnostics (Basel) Vol. 14; no. 4; p. 409
• Main Authors: Ionac, Ioana, Lazar, Mihai Andrei, Hoinoiu, Teodora, Crisan, Simina, Pescariu, Silvius Alexandru, Dima, Ciprian Nicusor, Luca, Constantin Tudor, Mornos, Cristian
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.02.2024
• Subjects: Body mass index; cardiac death; Cardiac patients; Cardiovascular disease; Chronic illnesses; early-stage heart failure; Health aspects; Heart; Heart failure; Heart rate; Hospital patients; Hospitals; Hypertension; Medical prognosis; Mortality; Patients; prognosis; Pulmonary arteries; rehospitalization; Romania; tissue Doppler imaging; Velocity; Romania; rehospitalization; cardiac death; prognosis; tissue Doppler imaging; early-stage heart failure
• ISSN: 2075-4418; 2075-4418
• DOI: 10.3390/diagnostics14040409

It has been shown that patients with NYHA class I and II have a high morbidity and mortality burden. We investigated the value of a new tissue Doppler index, E/(e' × s'), to predict cardiac events in the long-term follow-up of patients at an early stage of heart failure (HF). Sequential echocardiography was conducted on a consecutive cohort of 212 hospitalized HF patients, pre-discharged and with three-month follow-up. The primary end point consisted of cardiac death or readmission due to HF worsening. During follow-up, cardiac events occurred in 99 patients (46.7%). The first cardiac event was represented by cardiac death in 8 patients (3.8%) and readmission for HF in 91 patients (42.9%). A Kaplan-Meier analysis did not show a significantly different event-free survival rate between patients with NYHA class I and II. The composite end point was significantly higher in patients with an E/(e' × s') >1.6. The E/(e' × s') at discharge was the best independent predictor of cardiac events. Those exhibiting an E/(e' × s') > 1.6 at discharge, with a subsequent deterioration after three months, displayed the poorest prognosis concerning cardiac events, HF-related rehospitalization, and cardiac mortality (all < 0.05). In early-stage HF patients, an E/(e' × s') > 1.6 emerged as a robust predictor of clinical outcomes, especially when coupled with a deterioration in condition.