Echocardiographically Measured Ejection Fraction Still is a Strong Prognostic Tool in Patients with Coronary Heart Disease: a Long-term Retrospective Cohort Study --Ejection Fraction as a Prognosticator--

Background: Echocardiographically determined left ventricular ejection fraction (LVEF) is a prognosticator of coronary artery disease (CAD). However, few studies have shown the superiority of LVEF to cineangiographic or cardiopulmonary exercise measurements as a long-term prognostic tool of CAD. Methods and Results: We retrospectively followed up 204 consecutive patients with CAD. All underwent echocardiography, cineangiography, and cardiopulmonary exercise testing. There were 18 and 54 cardiac deaths during the first five-year and the entire 20-year follow-up period, respectively. Univariate Cox proportional regression analyses revealed that at 5 years from entry, the number of diseased vessels, LVEF, peak oxygen uptake (peak VO2), and the oxygen uptake efficiency slope (OUES), whilst at 20 years, age at entry, diagnosis (myocardial infarction), number of diseased vessels, LVEF, peak VO2, OUES, and the VE/VCO2 regression slope were proved to be significant prognosticators. However, multivariate Cox regression model revealed that only LVEF and OUES, and LVEF and peak VO2 were independent prognosticators after 5 years and 20 years, respectively. Conclusion: Echocardiographically measured LVEF still is the most valid tool in evaluating long-term prognosis of patients with CAD.