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Eur J Heart Fail. 2008 Aug;10(8):786-92. doi: 10.1016/j.ejheart.2008.06.005. Epub 2008 Jul 9.

Independence of restrictive filling pattern and LV ejection fraction with mortality in heart failure: an individual patient meta-analysis.

Collaborators (140)

Doughty RN, Gamble GD, Poppe KK, Somaratne JB, Whalley GA, Doughty RN, Klein AL, Poppe KK, Gamble GD, Dini FL, Møller JE, Quintana M, Yu CM, Whalley GA, Dini FL, Doughty RN, Gamble GD, Klein AL, Møller JE, Quintana M, Whalley GA, Yu CM, Bruch C, Feola M, Ghio S, Giannuzzi P, Hansen A, Ortiz J, Pinamonti B, Prior DL, Rossi A, Tabet JY, Temporelli PL, Yamamoto T, Prior DL, Monaco CG, Silva CE, Ferreira LD, Gil MA, Nanda NC, Monaco CA, Sanderson JE, Yu CM, Cohen-Solal A, Dahan M, Ennezat PV, Geyer C, Guiti C, Logeart D, Tabet JY, Breithardt G, Bruch C, Eckardt L, Gotzmann M, Grude M, Rothenburger M, Scheld HH, Stypmann J, Wenzelburger F, Wichter T, Haass M, Hansen A, Krueger C, Kuebler W, Kuecherer H, Unnebrink K, Zimmermann R, Zugck C, Bosimini E, Corrà U, Galli M, Giannuzzi P, Giordano A, Imparato A, Scapellato F, Silva P, Temporelli PL, Ajmone-Marsan N, Campana C, Gavazzi A, Ghio S, Klersy C, Laudisa ML, Recusani F, Sebastiani R, Tavazzi L, Baldini U, Boni A, Barsotti L, Cortigiani L, Dini FL, Micheli G, Nuti R, Rossi A, Cicoira M, Bonapace S, Camerini F, Di Lenarda A, Gregori D, Pinamonti B, Sinagra G, Zecchin M, Aspromonte N, Feola M, Giovinazzo P, Milani L, Valle R, Ishimoto T, Ito S, Oki T, Tabata T, Tanaka H, Wakatsuki T, Yamada H, Yamamoto T, Doughty RN, Gamble GD, Walsh HJ, Sharpe N, Whalley GA, Wright SP, Fogarty A, Frampton CM, Klein AL, Lauer MS, Martin M, Morehead AJ, Nash PJ, Pereira JJ, Prior DL, Starling RC, Tang W, Thomas JD, Troughton R, Young JB, Doughty RN, Gamble GD, MacMahon S, Sharpe DN, Whalley GA.



The Doppler echocardiographic restrictive mitral filling pattern (RFP) is an important prognostic indicator in patients with heart failure (HF), but the interaction between RFP, left ventricular ejection fraction (LVEF) and filling pattern remains uncertain.


To determine whether the RFP is predictive of mortality independently of LVEF in patients with HF.


Online databases were searched to identify studies assessing the relationship between prognosis and LV filling pattern in patients with HF. Individual patient data from 18 studies (3540 patients) were extracted and collated at the MeRGE Coordinating Centre (The University of Auckland).


Overall, RFP was associated with higher all-cause mortality than the non-restrictive filling pattern: hazard ratio 2.42 (95% CI 2.06, 2.83). In multivariable analysis the RFP, LVEF, NYHA class and age were independent predictors of mortality. The prevalence of the RFP was inversely related to LVEF but remained a predictor of mortality even in those patients with preserved LVEF.


The restrictive mitral filling pattern is a powerful predictor of mortality, independent of LVEF and age, in patients with HF. Doppler-derived LV filling patterns are an accessible marker from echocardiography that can readily be incorporated in risk stratification of all patients with HF.

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