Abstract
Background: Mortality following an admission for acute decompensated heart failure (ADHF) is high and risk stratification in this context remains a challenge. The objective of the present study was to assess whether a simple echocardiographic assessment of pulmonary hypertension (PH) and/or of right ventricular (RV) dysfunction is associated with cardiovascular events in a 1-year follow-up after hospital discharge. Methods and results: The present prospective longitudinal study included 214 patients admitted to hospital with a cardiologist-adjudicated diagnosis of ADHF and a left ventricular ejection fraction (LVEF) at echocardiography < 40%. Echocardiography was performed at admission and at discharge and included pulmonary artery systolic pressure (PASP) and RV function as defined by the tricuspid annular plane systolic displacement (TAPSE). The primary end-point was the combination of all-cause mortality and re-hospitalization for worsening heart failure at 1 year after hospital discharge. During an average follow-up period of 230 ± 130 days, 40 patients died and 41 patients underwent re-hospitalization due to ADHF. At multivariate analysis the independent predictors were LVEF, PASP at discharge and creatinine plasma levels (all p < 0.001). At ROC analysis the best threshold of PASP to discriminate low-risk from high-risk patients was 40 mm Hg. Conclusions: In ADHF patients with reduced LVEF, PH at discharge is a pivotal prognostic feature to predict morbidity/mortality within the first year after the acute episode.
| Original language | English |
|---|---|
| Journal | International Journal of Cardiology |
| DOIs | |
| Publication status | Accepted/In press - Jan 1 2018 |
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Keywords
- Heart failure
- Pulmonary hypertension
- Right ventricular function
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Prognostic significance of the echocardiographic estimate of pulmonary hypertension and of right ventricular dysfunction in acute decompensated heart failure. A pilot study in HFrEF patients. / Badagliacca, Roberto; Ghio, Stefano; Correale, Michele; Poscia, Roberto; Camporotondo, Rita; Ferraretti, Armando; Papa, Silvia; Pezzuto, Beatrice; Petrone, Pasquale; Torre, Roberto; Di Biase, Matteo; Novara, Paola; Guida, Stefania; Vizza, Carmine Dario.
In: International Journal of Cardiology, 01.01.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prognostic significance of the echocardiographic estimate of pulmonary hypertension and of right ventricular dysfunction in acute decompensated heart failure. A pilot study in HFrEF patients
AU - Badagliacca, Roberto
AU - Ghio, Stefano
AU - Correale, Michele
AU - Poscia, Roberto
AU - Camporotondo, Rita
AU - Ferraretti, Armando
AU - Papa, Silvia
AU - Pezzuto, Beatrice
AU - Petrone, Pasquale
AU - Torre, Roberto
AU - Di Biase, Matteo
AU - Novara, Paola
AU - Guida, Stefania
AU - Vizza, Carmine Dario
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: Mortality following an admission for acute decompensated heart failure (ADHF) is high and risk stratification in this context remains a challenge. The objective of the present study was to assess whether a simple echocardiographic assessment of pulmonary hypertension (PH) and/or of right ventricular (RV) dysfunction is associated with cardiovascular events in a 1-year follow-up after hospital discharge. Methods and results: The present prospective longitudinal study included 214 patients admitted to hospital with a cardiologist-adjudicated diagnosis of ADHF and a left ventricular ejection fraction (LVEF) at echocardiography < 40%. Echocardiography was performed at admission and at discharge and included pulmonary artery systolic pressure (PASP) and RV function as defined by the tricuspid annular plane systolic displacement (TAPSE). The primary end-point was the combination of all-cause mortality and re-hospitalization for worsening heart failure at 1 year after hospital discharge. During an average follow-up period of 230 ± 130 days, 40 patients died and 41 patients underwent re-hospitalization due to ADHF. At multivariate analysis the independent predictors were LVEF, PASP at discharge and creatinine plasma levels (all p < 0.001). At ROC analysis the best threshold of PASP to discriminate low-risk from high-risk patients was 40 mm Hg. Conclusions: In ADHF patients with reduced LVEF, PH at discharge is a pivotal prognostic feature to predict morbidity/mortality within the first year after the acute episode.
AB - Background: Mortality following an admission for acute decompensated heart failure (ADHF) is high and risk stratification in this context remains a challenge. The objective of the present study was to assess whether a simple echocardiographic assessment of pulmonary hypertension (PH) and/or of right ventricular (RV) dysfunction is associated with cardiovascular events in a 1-year follow-up after hospital discharge. Methods and results: The present prospective longitudinal study included 214 patients admitted to hospital with a cardiologist-adjudicated diagnosis of ADHF and a left ventricular ejection fraction (LVEF) at echocardiography < 40%. Echocardiography was performed at admission and at discharge and included pulmonary artery systolic pressure (PASP) and RV function as defined by the tricuspid annular plane systolic displacement (TAPSE). The primary end-point was the combination of all-cause mortality and re-hospitalization for worsening heart failure at 1 year after hospital discharge. During an average follow-up period of 230 ± 130 days, 40 patients died and 41 patients underwent re-hospitalization due to ADHF. At multivariate analysis the independent predictors were LVEF, PASP at discharge and creatinine plasma levels (all p < 0.001). At ROC analysis the best threshold of PASP to discriminate low-risk from high-risk patients was 40 mm Hg. Conclusions: In ADHF patients with reduced LVEF, PH at discharge is a pivotal prognostic feature to predict morbidity/mortality within the first year after the acute episode.
KW - Heart failure
KW - Pulmonary hypertension
KW - Right ventricular function
UR - http://www.scopus.com/inward/record.url?scp=85046737842&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85046737842&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2018.04.069
DO - 10.1016/j.ijcard.2018.04.069
M3 - Article
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -