Prognostic stratification of patients with chronic systolic heart failure using biomarkers and Doppler echocardiography.

Aims: To verify whether a combined assessment of left-ventricular filling pattern at Doppler echocardiography, plasma levels of brain natriuretic peptide (BNP) and high-sensitive troponin I (hsTnI) improves prognostic stratification in patients with chronic systolic heart failure.

Methods: Three predictors of prognosis were evaluated in 200 consecutive outpatients with heart failure and left-ventricular ejection fraction 35% or less: left-ventricular filling pattern at Doppler echocardiography, BNP plasma levels and hsTnI plasma levels.

Results: During a median follow-up period of 44 months, 15 deaths, two urgent cardiac transplantations, two episodes of ventricular fibrillation and 50 heart failure hospitalizations were observed.

Analyses of longitudinal and of transverse right ventricular function provide different clinical information in patients with pulmonary hypertension.

We tested the hypothesis that analysis of longitudinal right ventricular (RV) function and analysis of transverse RV function by echocardiography provide different clinical information in patients with pulmonary hypertension (PH). Indices of longitudinal and transverse RV function were obtained with different echocardiographic techniques in 30 patients with idiopathic pulmonary arterial hypertension, 28 patients with systolic left ventricular dysfunction and PH (sLVD PH), 27 patients with sLVD and normal pulmonary pressure (sLVD no PH) undergoing right heart catheterization and 20 healthy patients. Indices of RV transverse function were significantly worse in patients with PH than in patients without PH and did not statistically differ between patients with normal and those with reduced cardiac index; RV diameter shortening at mid-segment correlated best with mean pulmonary artery pressure (h = 0.

Clinical and prognostic relevance of echocardiographic evaluation of right ventricular geometry in patients with idiopathic pulmonary arterial hypertension.

The aim of the present study was to assess the clinical and prognostic significance of right ventricular (RV) dilation and RV hypertrophy at echocardiography in patients with idiopathic pulmonary arterial hypertension. Echocardiography and right heart catheterization were performed in 72 consecutive patients with idiopathic pulmonary arterial hypertension admitted to our institution. The median follow-up period was 38 months.

Inappropriate exercise-induced increase in pulmonary artery pressure in patients with systemic sclerosis.

Background: Recent data show that there is an unexpectedly high prevalence of 'inappropriate' pulmonary responses to exercise among patients with systemic sclerosis (SS). However, no consensus exists as to which threshold of pulmonary artery systolic pressure (PASP) can be considered diagnostically relevant.

Aim: To evaluate pulmonary vascular reserve and right ventricular function changes induced by exercise in SS patients without overt pulmonary arterial hypertension.