Abstract 11578: Predicting 30- and 90-day Hospital Admission Rates Using 3-Dimensional Echocardiography Volume-Curve Parameters

Introduction: This study compares impact of 3D echocardiography-derived novel volume-time parameters to established diastolic dysfunction grades with the aim to improve diagnostic and prognostic prediction of hospital admissions.

Methods: Subjects (100 heart-failure (HF) and 11 controls) completed 3D-echocardiograms. Under 2016 ASE Guidelines ‘normal’ and ‘grade 1’ were classified as ‘lower-grade’ (n=64), while ‘grade 2’ and ‘grade 3’ as ‘higher-grade’ (n=38). Early passive filling rate to late passive filling rate ratio was calculated, with early-filling and atrial contraction volumes normalized to total filling volume and body surface area. VC based analysis was classified into ‘normal’ (n=37; atrial contraction enhanced, normal, early enhanced) and ‘abnormal’ (n=74; mid-filling enhanced, delayed filling and restrictive-constrictive). Both methods were compared for 30- and 90-day hospital admissions.

Results: The mean age is 67.4 years (SD: 11.1) with 51.4% male. Overall, 9.0% (n=10) and 16.2% (n=18) of the subjects were admitted within 30-days and 90- days, respectively. For 30-day admission, 60% and 40% were lower-grade and higher-grade groups by ASE, respectively, (hazard ratio [HR], 0.91; 95% confidence interval [CI], 0.26 to 3.23, p-value = 0.89); For admission within 90-days, 50% were in lower-grade and 50% in higher-grade groups of ASE, respectively, (HR 1.37; 95% CI, 0.54 to 3.45, p-value = 0.51). Kaplan-Meier curves and log rank test showed significant differences between VC groups with (p-value =0.021 and p-value<0.001) in at risk of admission within 30- and 90-days, respectively.

Conclusions: Volume curve analysis provides a better diagnostic and prognostic tool for predicting near term hospital admissions in HF patients. Kaplan-Meier Curves depicting admission within 30- and 90- days by VC and ASE Group