{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T18:11:24Z","timestamp":1781115084070,"version":"3.54.1"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>The assessment of left ventricular (LV) outflow velocity time integral (LVOT\u2010VTI) has gained favor in the stratification of patients with heart failure (HF). We evaluated the prognostic significance of LVOT\u2010VTI compared with the commonly used indices of LV outflow: cardiac index (CI) and stroke volume index (SVI), their reproducibility and cut\u2010off values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>\n                      A total of 424 outpatients diagnosed with HF and LV systolic dysfunction (LV ejection fraction &lt;\u00a050%) underwent a Doppler echocardiographic examination, including the assessment of CI, SVI, and LVOT\u2010VTI. The Bland\u2013Altman analysis showed LVOT\u2010VTI the most reproducible outflow index. The study follow\u2010up duration was 3.5 years (interquartile range 1.6\u20136.5), at the end of which there were 94 cardiovascular deaths (29%). Cox regression univariate analysis showed that LVOT\u2010VTI was the most predictive of the study end\u2010point. The ratio of tricuspid annular displacement\u2010to\u2010pulmonary artery systolic pressure (TAPSE\/PASP) (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001), LVOT\u2010VTI (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0011), and end\u2010systolic volume index (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0036) independently predicted the study end\u2010point. At receiver\u2010operating characteristic (ROC) analysis, LVOT\u2010VTI &lt;\u00a012.0\u00a0cm had the best sensitivity and specificity for predicting cardiovascular mortality. Reduced LV EF (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0011), raised BNP levels (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0053), and high LV filling pressure (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.044) were associated with low LVOT\u2010VTI in multivariate logistic regression analysis. Patients with low LVOT\u2010VTI and TAPSE\/PASP\u00a0&lt;\u00a00.32\u00a0mm\/mmHg exhibited the worst prognosis on Kaplan\u2013Meier survival curves (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A LVOT\u2010VTI &lt;\u00a012.0\u00a0cm represents the best predictor of the cardiovascular outcome and proved the most reproducible index of LV forward flow in patients with chronic HF and systolic dysfunction. The combination of impaired LVOT\u2010VTI with TAPSE\/PASP showed the worst survival.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70109","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T02:50:49Z","timestamp":1740019849000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Left Ventricular Outflow Indices in Chronic Systolic Heart Failure: Thresholds and Prognostic Value"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1458-4820","authenticated-orcid":false,"given":"Frank L.","family":"Dini","sequence":"first","affiliation":[{"name":"Istituto Auxologico, IRCCS  Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Barletta","sequence":"additional","affiliation":[{"name":"Cardiac, Thoracic and Vascular Department University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piercarlo","family":"Ballo","sequence":"additional","affiliation":[{"name":"Cardiology Operative Unit Santa Maria Annunziata Hospital  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cioffi","sequence":"additional","affiliation":[{"name":"Cardiac Rehabilitation Centre San Pancrazio Hospital  Trento Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5473-227X","authenticated-orcid":false,"given":"Nicola Riccardo","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Department of Clinical and Experimental Medicine University of Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7095-7121","authenticated-orcid":false,"given":"Andrea","family":"Rossi","sequence":"additional","affiliation":[{"name":"Cardiology Operative Unit Magalini Hospital  Villafranca (Verona) Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gani","family":"Bajraktari","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology University Clinical Centre of Kosovo  Prishtina Kosovo"},{"name":"Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1858-1152","authenticated-orcid":false,"given":"Stefano","family":"Ghio","sequence":"additional","affiliation":[{"name":"UOS Cardiomiopatie Trapiantologia e Ipertensione polmonare, UOC Cardiologia 1, Fondazione IRCCS Policlinico San Matteo  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y.","family":"Henein","sequence":"additional","affiliation":[{"name":"Imperial College London  London UK"},{"name":"Division of Cardiology Department of Medical Biotechnologies University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells9010242"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.3622.1033"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2115"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1067\/mje.2002.120202"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2019.09.009"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554\u2010021\u201002457\u2010z"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13089\u2010020\u201000170\u2010x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.10.003"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeab253"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2011.225789"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.05.075"},{"issue":"3","key":"e_1_2_7_13_1","first-page":"162","article-title":"Ventricular Remodeling and Its Prevention in the Treatment of Heart Failure","volume":"13","author":"Patten R. 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