Prognostic Implications of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Diameter on Clinical Outcomes in Patients with ICD
Background: Left ventricular ejection fraction (LVEF) is a suboptimal indicator of risk stratification for patients with an implantable cardioverter defibrillator (ICD). Studies have shown that left ventricular end-diastolic diameter (LVEDD) was associated with all-cause mortality and ventricular ar...
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MDPI AG
2022-11-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/12/421 |
| _version_ | 1827638368457981952 |
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| author | Sijing Cheng Yu Deng Hao Huang Xi Liu Yu Yu Xuhua Chen Min Gu Hongxia Niu Wei Hua |
| author_facet | Sijing Cheng Yu Deng Hao Huang Xi Liu Yu Yu Xuhua Chen Min Gu Hongxia Niu Wei Hua |
| author_sort | Sijing Cheng |
| collection | DOAJ |
| description | Background: Left ventricular ejection fraction (LVEF) is a suboptimal indicator of risk stratification for patients with an implantable cardioverter defibrillator (ICD). Studies have shown that left ventricular end-diastolic diameter (LVEDD) was associated with all-cause mortality and ventricular arrhythmias. We examined the quantified prognostic value of LVEF and LVEDD for clinical outcomes, respectively. Method: This study retrospectively enrolled patients with ICD implantation in a single center. The associations between LVEF or LVEDD and all-cause mortality and appropriate shocks were analyzed using Cox regression and Fine-gray competing risk regression, respectively. Result: During a median follow up of 59.6 months, 168/630 (26.7%) patients died. LVEF and LVEDD were strongly associated with all-cause mortality (LVEF per 10%: HR 0.77, 95%CI 0.64–0.93, <i>p</i> = 0.006; LVEDD per 10 mm: HR 1.54, 95%CI 1.27–1.85, <i>p</i> < 0.001). After a median interrogation time of 37.1 months, 156 (24.8%) patients received at least one shock. LVEF was not associated with appropriate shock, whereas larger LVEDD (per 10 mm) was significantly associated with a higher risk of shock (HR: 1.27, 95%CI 1.06–1.52, <i>p</i> = 0.008). The addition of LVEF or LVEDD to clinical factors provided incremental prognostic value and discrimination improvement for all-cause mortality, while only the addition of LVEDD to clinical factors improved prognostic value for shock intervention. Conclusions: Baseline LVEF and LVEDD show a linear relationship with all-cause mortality in patients with ICD. However, whereas LVEF is not associated with shock, a linear relationship exists between LVEDD and appropriate shock. LVEDD adds more predictive value in relation to all-cause mortality and appropriate shocks than LVEF. |
| first_indexed | 2024-03-09T16:16:27Z |
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| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T16:16:27Z |
| publishDate | 2022-11-01 |
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| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-0aad670db02f4373a7a1afef9e6a5f7d2023-11-24T15:41:30ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-11-0191242110.3390/jcdd9120421Prognostic Implications of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Diameter on Clinical Outcomes in Patients with ICDSijing Cheng0Yu Deng1Hao Huang2Xi Liu3Yu Yu4Xuhua Chen5Min Gu6Hongxia Niu7Wei Hua8State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Beijing 100037, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Beijing 100037, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Beijing 100037, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Beijing 100037, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Beijing 100037, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Beijing 100037, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Beijing 100037, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Beijing 100037, ChinaState Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.167 North Lishi Road, Beijing 100037, ChinaBackground: Left ventricular ejection fraction (LVEF) is a suboptimal indicator of risk stratification for patients with an implantable cardioverter defibrillator (ICD). Studies have shown that left ventricular end-diastolic diameter (LVEDD) was associated with all-cause mortality and ventricular arrhythmias. We examined the quantified prognostic value of LVEF and LVEDD for clinical outcomes, respectively. Method: This study retrospectively enrolled patients with ICD implantation in a single center. The associations between LVEF or LVEDD and all-cause mortality and appropriate shocks were analyzed using Cox regression and Fine-gray competing risk regression, respectively. Result: During a median follow up of 59.6 months, 168/630 (26.7%) patients died. LVEF and LVEDD were strongly associated with all-cause mortality (LVEF per 10%: HR 0.77, 95%CI 0.64–0.93, <i>p</i> = 0.006; LVEDD per 10 mm: HR 1.54, 95%CI 1.27–1.85, <i>p</i> < 0.001). After a median interrogation time of 37.1 months, 156 (24.8%) patients received at least one shock. LVEF was not associated with appropriate shock, whereas larger LVEDD (per 10 mm) was significantly associated with a higher risk of shock (HR: 1.27, 95%CI 1.06–1.52, <i>p</i> = 0.008). The addition of LVEF or LVEDD to clinical factors provided incremental prognostic value and discrimination improvement for all-cause mortality, while only the addition of LVEDD to clinical factors improved prognostic value for shock intervention. Conclusions: Baseline LVEF and LVEDD show a linear relationship with all-cause mortality in patients with ICD. However, whereas LVEF is not associated with shock, a linear relationship exists between LVEDD and appropriate shock. LVEDD adds more predictive value in relation to all-cause mortality and appropriate shocks than LVEF.https://www.mdpi.com/2308-3425/9/12/421implantable cardioverter defibrillatorleft ventricular ejection fractionleft ventricular end-diastolic diameterclinical outcomes |
| spellingShingle | Sijing Cheng Yu Deng Hao Huang Xi Liu Yu Yu Xuhua Chen Min Gu Hongxia Niu Wei Hua Prognostic Implications of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Diameter on Clinical Outcomes in Patients with ICD Journal of Cardiovascular Development and Disease implantable cardioverter defibrillator left ventricular ejection fraction left ventricular end-diastolic diameter clinical outcomes |
| title | Prognostic Implications of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Diameter on Clinical Outcomes in Patients with ICD |
| title_full | Prognostic Implications of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Diameter on Clinical Outcomes in Patients with ICD |
| title_fullStr | Prognostic Implications of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Diameter on Clinical Outcomes in Patients with ICD |
| title_full_unstemmed | Prognostic Implications of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Diameter on Clinical Outcomes in Patients with ICD |
| title_short | Prognostic Implications of Left Ventricular Ejection Fraction and Left Ventricular End-Diastolic Diameter on Clinical Outcomes in Patients with ICD |
| title_sort | prognostic implications of left ventricular ejection fraction and left ventricular end diastolic diameter on clinical outcomes in patients with icd |
| topic | implantable cardioverter defibrillator left ventricular ejection fraction left ventricular end-diastolic diameter clinical outcomes |
| url | https://www.mdpi.com/2308-3425/9/12/421 |
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