U-Shaped Relationship of Left Ventricular Ejection Time Index and All-Cause Mortality

Haiden, Anton; Eber, Bernd; Weber, Thomas

doi:10.1093/ajh/hpt185

Cited by 18 publications

(22 citation statements)

References 28 publications

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“…Shorter SET is associated with other clinical variables suggestive of poorer prognosis in HF, including lower ejection fraction (EF), cardiac index, and global longitudinal strain and a more rapid heart rate . In addition, shorter SET has been associated with poor prognosis in patients with cardiac amyloid while SET has a U‐shaped relationship for mortality among patients with coronary artery disease . SET is also associated with incident HF .…”

Section: Introductionmentioning

confidence: 99%

Association between systolic ejection time and outcomes in heart failure by ejection fraction

Patel¹,

Ambrosy

Phelan

et al. 2019

European J of Heart Fail

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Section: Introductionmentioning

confidence: 99%

Association between systolic ejection time and outcomes in heart failure by ejection fraction

Patel¹,

Ambrosy

Phelan

et al. 2019

European J of Heart Fail

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“…Ltd, West Ryde, Australia) to obtain aortic pressure waveforms by applying a generalized transfer function [5]. The estimate of ejection duration (ED) provided by the SphygmoCor system was indexed to heart rate (HR) to obtain the gender-specific ejection time index LVETI [16]. Echocardiographic examination was carried out immediately before or after pressure measurement using a Philips iE33 Ultrasound machine (Philips Medical Systems, Andover, Massachusetts).…”

Section: Methodsmentioning

confidence: 99%

Wave intensity of aortic root pressure as diagnostic marker of left ventricular systolic dysfunction

et al. 2017

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BackgroundSystolic left ventricular function strongly influences the blood pressure waveform. Therefore, pressure-derived parameters might potentially be used as non-invasive, diagnostic markers of left ventricular impairment. The aim of this study was to investigate the performance of pressure-based parameters in combination with electrocardiography (ECG) for the detection of left ventricular systolic dysfunction defined as severely reduced ejection fraction (EF).Methods and resultsTwo populations, each comprising patients with reduced EF and pressure-matched controls, were included for the main analysis (51/102 patients) and model testing (44/88 patients). Central pressure was derived from radial readings and used to compute blood flow. Subsequently, pulse wave analysis and wave intensity analysis were performed and the ratio of the two peaks of forward intensity (SDR) was calculated as a novel index of ventricular function. SDR was significantly decreased in the reduced EF group (2.5 vs. 4.4, P<0.001), as was central pulse pressure, augmentation index and ejection duration (ED), while the QRS-duration was prolonged. SDR and ED were independent predictors of ventricular impairment and when combined with QRS in a simple decision tree, a reduced EF could be detected with a sensitivity of 92% and a specificity of 80%. The independent power of ED, SDR and QRS to predict reduced EF was furthermore confirmed in the test population.ConclusionThe detection or indication of reduced ejection fraction from pressure-derived parameters seems feasible. These parameters could help to improve the quality of cardiovascular risk stratification or might be used in screening strategies in the general population.

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“…Data are stored at a cloud-based server (Amazon Web Services, Amazon Web Services EMEA SARL, 1855 Luxembourg, Luxemburg) equipped with safe data protection which conforms to the applicable regulations. The automatically calculated parameters that this study focuses on are: mean interbeat interval (IBI -ms), heart rate (HR 1/min), stiffness index (calculated as the height of the subject over pulse transit time PTT -m/s [5] [11]), reflection index (the ratio of the amplitude of the diastolic peak to the amplitude of the systolic peak); left ventricular ejection time index (LVETI -ejection time (ET) normalized for heart rate using the formulae LVETI = 1.7 × heart rate + ET, and LVETI = 1.6 × heart rate + ET in males and females, respectively [13]), b/a (parameter relating the amplitude of the second wave of the DVP second derivative to the first wave), d/a (ratio of the fourth and first inflection points of the second derivative of the DVP), aging index (a parameter derived from the amplitudes of inflections of the second derivative of the DVP as b-c-d-e/a [26]), and c-d point detection ratio (a value that specifies the percentage of those pulse cycles in the 2-minute recording in which c and d points of the second derivative were successfully identified by the algorithm) ( Figure 2).…”

Section: Place Holder For Figurementioning

confidence: 99%

Preclinical Assessment of a Novel Cardiovascular Telemedicine System

Antali¹,

Kulin²,

Wafa

et al. 2020

Preprint

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Background Introduction of telemonitoring systems to patient care which provide extensive information about the cardiovascular status of the patient is a promising direction to reduce cardiovascular morbidity and mortality. Our team has developed a telemedical system which is based on the photoplethysmographic detection of the digital arterial pulse wave. The system incorporates a cloud-based automated algorithm which analyses the pulse contour to provide 15 scientifically established parameters for versatile characterization of cardiovascular function. The aim of the current study was to assess the variability of the measurements to test the applicability of the tool before clinical use. We assessed the repeatability of the measurements by detecting stable artificial signals, and also test-retest variability by repeatedly examining the pulse contours of healthy individuals under standardized conditions. Results Most contour parameters (stiffness index, reflection index, left ventricular ejection time index and mean interbeat intervals) are measured with high repeatability (coefficients of variation (CV) < 1% for each parameter), and exhibit acceptable intrapersonal fluctuations (CVs < 10%). However, some parameters derived from the second derivative of the pulse wave seem to be more variable (aging index, d/a ratio). This is explained by the typical alterations of the pulse wave under specific circumstances, which cause the flattening or complete disappearance of c and d inflections on the second derivative. Conclusion Our measurements proved that our telemonitoring system detects and analyses digital pulse contours with high accuracy and highlighted that second derivative parameters should be interpreted cautiously. We recommend the evaluation of these parameters only in those measurements where c and d points are detected reliably. Pulse contour parameters are stable in healthy individuals under standardized conditions, which allows detection of subtle abnormal alterations by the remote surveillance system.

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U-Shaped Relationship of Left Ventricular Ejection Time Index and All-Cause Mortality

Abstract: We observed a U-shaped relation between ejection duration and all-cause mortality.

Cited by 18 publications

References 28 publications

Association between systolic ejection time and outcomes in heart failure by ejection fraction

Association between systolic ejection time and outcomes in heart failure by ejection fraction

Wave intensity of aortic root pressure as diagnostic marker of left ventricular systolic dysfunction

Preclinical Assessment of a Novel Cardiovascular Telemedicine System

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