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The researchers found that the change in log2-N terminal pro-b-type natriuretic peptide concentration was associated with changes in LVEF, LVEDVI, LVESVI, LAVI, and E/e' ratio.
The dependent variable for this multivariate general linear model was the LAVi change between the two assessments, and the independent variables included age, race, baseline LVEDVi and LVESVi, creatinine, ACE-I use, nitrate use, LVEF, early and late mitral inflow velocities and their ratio, deceleration time, septal, mitral, and average mitral annular velocities, the ratio of the mitral inflow velocity to the average mitral annular velocity, and the changes in these variables between the two assessments.
With the stepwise variable selection, the multivariate logistic regression model selected the following five risk factors, which independently predicted the probability of maintaining a normal LAVi over time: younger age (OR 1.18, CI 1.06-1.31, p < 0.01), white race (OR 7.43, CI 0.90-61.52, p = 0.06), being on ACE-I therapy (OR 3.67, CI 0.54-25.17, p = 0.19), decreased LVEDVi (OR 1.04, CI 0.99-1.08, p = 0.11), and longer deceleration time (OR 1.02, CI 1.00-1.04, p = 0.03).
Baseline factors including younger age, white race, being on ACE-I therapy, decreased LVEDVi, higher early-to-late mitral inflow velocity, and longer deceleration time were independently associated with having a normal LAVi.
In the present study, smaller LVEDVi correlated with having a normal LAVi, consistent with our physiological understanding of pressure volume loops.
In a carefully assessed group of patients with moderate-to-severely reduced LVEF, younger age, white race, being on ACE-I therapy, smaller LVEDVi, and longer deceleration time were associated with maintaining a normal LAVi over a period of at least 6 months.
LVEDVI is an anatomical measurement of ventricular remodeling that was measured by 3-D and 2-D echocardiography.
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