Prognostic Value of Pulsed Tissue Doppler Imaging for the Assessment of Left Ventricular Systolic Function in Patients with Nonischemic Dilated Cardiomyopathy

Abstract There is still some debate regarding the prognostic significance of left ventricular longitudinal systolic dysfunction as assessed by tissue Doppler (TD) imaging in patients with chronic heart failure (HF), since previous studies have included patients with postischemic wall motion abnormalities. Thus, this study was designed to ascertain whether TD-derived longitudinal systolic dysfunction may influence the outcome of patients with nonischemic chronic HF. In 200 consecutive patients with chronic HF secondary to dilated cardiomyopathy and no history of ischemic heart disease, peak systolic mitral annular velocity (S(m) ) was measured by pulsed TD at the septal and lateral annular sites. The end points were cardiac death or hospitalization for worsening HF. Mean follow-up duration was 30 months. In a time independent analysis, averaged S(m) calculated as the average of septal and lateral S(m) , resulted to be a significant predictor of outcome in the study population (area under receiver-operator characteristic curve: cardiovascular death, 0.69, P < 0.0001; cardiovascular events, 0.64, P = 0.0005). In a time-dependent analysis, average S(m) was associated with both cardiovascular death (hazard ratio 0.832, P = 0.0019) and cardiovascular events (hazard ratio 0.904, P = 0.039), independently of other clinical risk factors and echocardiographic parameters of systolic function. Septal S(m) but not lateral S(m) was independently associated with the outcome measures. In conclusion, the assessment of systolic mitral annular velocity by pulsed TD is a useful indicator for prognostic stratification of patients with nonischemic dilated cardiomyopathy and chronic HF. (Echocardiography ****;**:1-7)

Probing brand luxury: a multiple lens approach

Research relevant to the creation and development of luxury brands is a growing area of interest and importance to branding practitioners and scholars. The issue here is that it is difficult to move forward when current brand luxury theory resembles a patchwork of definitions, methods and metrics. To add clarity, delineate brand luxury from other similar terms and concepts, and improve brand luxury knowledge, this article probes brand luxury through seven lenses. The findings enable brand luxury practice and theory to move forward on the basis of scientific merit. The results delineate brand luxury from competing terms such as brand status and prestigious brands – enabling practitioners and academics to precisely determine the extent to which luxury contributes to a brand, resolve whether or not a brand is a luxury brand, and establish with some accuracy the net worth of the brand luxury market