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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

PREDICTIVE VALUE OF dP/dt AND-dP/dt AS SURVIVAL PARAMETERS IN PATIENTS WITH CONGESTIVE HEART FAILURE
E. Talirević, M. Talirević, N. Nabil and Al-Tawil Dj.
Clinic for Cardiac and Rheumatic Diseases1, Clinical Center University of Sarajevo, General Hospital Sarajevo2, Sarajevo, Bosnia and Herzegovina

Congestive heart failure represents one of the most frequently encountered care problems. Especially difficult task is the identification of patients at highest risk of experience sudden cardiac death, myocardial infraction or acute pulmonary edema, who could benefit of extremely aggressive treatment and are potential candidates for cardiac transplantation. The goal of this study was to analyse two Doppler parameters of left ventricular systolic and diastolic function and to determine their predictive value in estimating survival. Total of 37 (thirty-seven) patients entered the study. All patients were hospitalised at the Clinic for Cardiac and Rheumatic Diseases with symptoms of heart failure (NYHA Class III and IV). Doppler parameters dP/dt and -dP/dt were obtained by an off -line analysis of mitral regurgitation jet. Average patients' age was 59,8 years, mean ejection fraction (EF) was 24%. With the goal of comprehensive analysis echocardiographic and laboratory parameters were obtained from all patients. Primary end point was cardiac mortality at 30 days. By the study end, thirteen patients died. Using statistical analysis, three groups with dP/dt and -dP/dt parameters were formed, each entailing different prognosis; low-risk group with dP/dt>600 mmhg/s, intermediate-risk group with dP/dt<600 mmHg/s and -dP/dt>450 mmHg/s, and high-risk group with dP/dt< 600 mmHg/s and -dP/dt< 450 mmHg/s. Multivariate analysis of different parameters showed that these Doppler risk groups, the need for inotropic support and blood urea nitrogen (BUN) represented the most useful prognostic parameters.

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