Abstract
OBJECTIVE: The aim of this study was to investigate the prognostic value of visually assessed time difference between mitral valve and tricuspid valve opening (VMT) score in patients with acute heart failure (AHF). METHODS: Potential confounding factors associated with all-cause and cardiovascular disease (CVD)-cause mortality in AHF patients were explored using a univariate Cox regression model, and the relationship between the VMT score and all-cause/CVD-cause mortality was analyzed using a multivariable Cox regression model. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used as the effect size. The prognostic value of the VMT score was evaluated using the C-index. RESULTS: The all-cause mortality rate and CVD-cause mortality rate in the VMT score < 2 group were lower than in the VMT score ≥ 2 group. VMT score > 2 was correlated with an elevated risk of all-cause mortality in the AHF patients (HR = 1.97, 95% CI: 1.20-3.25). An increased risk of CVD-cause mortality was observed in the VMT score > 2 group. The C-index of the VMT score for all-cause mortality in the AHF patients was 0.621 (95% CI: 0.570-0.672), while for CVD-cause mortality it was 0.644 (95% CI: 0.573-0.715). Combining the VMT score with variables associated with all-cause mortality and CVD-cause mortality, the C-index of the VMT score-based model for all-cause mortality in the AHF patients was 0.859 (95% CI: 0.820-0.898), while for CVD-cause mortality it was 0.872 (95% CI: 0.825-0.919). CONCLUSIONS: The VMT score showed moderate prognostic value for all-cause and CVD-cause mortality in patients with AHF. Combining the VMT score with other related variables resulted in good prognostic value for all-cause and CVD-cause mortality in patients with AHF.