Background: Peak tricuspid regurgitation (TR) velocity and inferior cava vein (ICV) distention are two recognized features of increased pulmonary artery pressure (PASP) and right atrial pressure, respectively. Both parameters are related to pulmonary and systemic congestion and adverse outcomes. However, few data exist about the assessment of PASP and ICV in acute patients affected by heart failure with preserved ejection fraction (HFpEF). Thus, we investigated the relationship existing among clinical and echocardiographic features of congestion, and we analyzed the prognostic impact of PASP and ICV in acute HFpEF patients.
Methods And Results: We analyzed clinical congestion PASP and ICV value in consecutive patients admitted in our ward by echocardiographic examination using peak Doppler velocity tricuspid regurgitation and ICV diameter and collapse for the assessment of PASP and ICV dimension, respectively. A total of 173 HFpEF patients were included in the analysis. The median age was 81 and median left ventricular ejection fraction (LVEF) was 55% [50-57]. Mean values of PASP was 45 mmHg [35-55] and mean ICV was 22 [20-24] mm. Patients with adverse events during follow-up showed significantly higher values of PASP (50 [35-55] vs. 40 [35-48] mmHg, ( = 0.005) and increased values of ICV (24 [22-25] vs. 22 [20-23] mm, < 0.001). Multivariable analysis showed prognostic power of ICV dilatation (HR 3.22 [1.58-6.55], = 0.001) and clinical congestion score ≥ 2 (HR 2.35 [1.12-4.93], = 0.023), but PASP increase did not reach statistical significance ( = 0.874). The combination of PASP > 40 mmHg and ICV > 21 mm was capable of identifying patients with increased events (45% vs. 20%).
Conclusions: ICV dilatation provides additional prognostic information with respect to PASP in patients with acute HFpEF. A combined model adding PASP and ICV assessment to clinical evaluation is a useful tool for predicting HF related events.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9955829 | PMC |
| http://dx.doi.org/10.3390/diagnostics13040692 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Different right ventricular dysfunction and pulmonary coupling in acute heart failure according to the left ventricular ejection fraction.
Prog Cardiovasc Dis
December 2023
Cardiology Unit, "Buon Consiglio Hospital" Fatebenefratelli, Naples, Italy.
Background: Right ventricular (RV) dysfunction and pulmonary uncoupling are two acknowledged features associated with poor outcome, however few data defined RV adaptation across the different left ventricular ejection fraction (EF) cut-off. Additionally, less data are reported in patients with acute heart failure (AHF).
Aims: The aim of present study was to analyse RV function in AHF patients presenting with either reduced or preserved EF.
Pulmonary Artery Systolic Pressure and Cava Vein Status in Acute Heart Failure with Preserved Ejection Fraction: Clinical and Prognostic Implications.
Diagnostics (Basel)
February 2023
Cardiovascular Diseases Unit, Cardio Thoracic and Vascular Department, Le Scotte hospital University of Siena, 53100 Siena, Italy.
Background: Peak tricuspid regurgitation (TR) velocity and inferior cava vein (ICV) distention are two recognized features of increased pulmonary artery pressure (PASP) and right atrial pressure, respectively. Both parameters are related to pulmonary and systemic congestion and adverse outcomes. However, few data exist about the assessment of PASP and ICV in acute patients affected by heart failure with preserved ejection fraction (HFpEF).
View Article and Find Full Text PDFNon-invasive assessment of acute heart failure by Stevenson classification: Does echocardiographic examination recognize different phenotypes?
Front Cardiovasc Med
September 2022
Division of Cardiology and Center for Clinical and Translational Research - CERICLET, University of Perugia, Perugia, Italy.
Background: Acute heart failure (AHF) presentation is universally classified in relation to the presence or absence of congestion and the peripheral perfusion condition according to the Stevenson diagram. We sought to evaluate a relationship existing between clinical assessment and echocardiographic evaluation in patients with AHF.
Materials And Methods: This is a retrospective blinded multicenter analysis assessing both clinical and echocardiographic analyses during the early hospital admission for AHF.
Acute right ventricular dysfunction in severe COVID-19 pneumonia.
Rev Cardiovasc Med
December 2020
Department of Intensive Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, P. R. China.
To investigate the right heart function in coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome (ARDS), a retrospective analysis of 49 COVID-19 patients with ARDS was performed. Patients were divided into severe group and critically-severe group according to the severity of illness. Age-matched healthy volunteers were recruited as a control group.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!