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

Roberto Badagliacca, Stefano Ghio, Michele Correale, Roberto Poscia, Rita Camporotondo, Armando Ferraretti, Silvia Papa, Beatrice Pezzuto, Pasquale Petrone, Roberto Torre, Matteo Di Biase, Paola Novara, Stefania Guida, Carmine Dario Vizza

Research output: Contribution to journalArticle

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 languageEnglish
JournalInternational Journal of Cardiology
DOIs
Publication statusAccepted/In press - Jan 1 2018

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Right Ventricular Dysfunction
Pulmonary Hypertension
Heart Failure
Stroke Volume
Pulmonary Artery
Blood Pressure
Echocardiography
Mortality
Hospitalization
Right Ventricular Function
ROC Curve
Longitudinal Studies
Creatinine
Multivariate Analysis
Prospective Studies
Morbidity

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 journalArticle

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. / 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. In: International Journal of Cardiology. 2018.
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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.

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KW - Right ventricular function

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