Prognostic value of an echocardiographic index reflecting right ventricular operating stiffness in patients with heart failure

Purpose We recently reported a noninvasive method for the assessment of right ventricular (RV) operating stiffness that is obtained by dividing the atrial-systolic descent of the pulmonary artery-RV pressure gradient (PRPGD AC ) derived from the pulmonary regurgitant velocity by the tricuspid annula...

Full description

Saved in:
Bibliographic Details
Published in:Heart and vessels 2022-04, Vol.37 (4), p.583-592
Main Authors: Fujisawa, Ryosuke, Okada, Kazunori, Kaga, Sanae, Murayama, Michito, Nakabachi, Masahiro, Yokoyama, Shinobu, Nishino, Hisao, Tanemura, Asuka, Masauzi, Nobuo, Motoi, Ko, Ishizaka, Suguru, Chiba, Yasuyuki, Tsujinaga, Shingo, Iwano, Hiroyuki, Anzai, Toshihisa
Format: Article
Language:English
Subjects:
Biomedical Engineering and Bioengineering
Brain natriuretic peptide
Cardiac Surgery
Cardiology
Congestive heart failure
Diuretics
Heart failure
Medicine
Medicine & Public Health
Original Article
Parameters
Prognosis
Pulmonary arteries
Pulmonary artery
Regression analysis
Stiffness
Vascular Surgery
Ventricle
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose We recently reported a noninvasive method for the assessment of right ventricular (RV) operating stiffness that is obtained by dividing the atrial-systolic descent of the pulmonary artery-RV pressure gradient (PRPGD AC ) derived from the pulmonary regurgitant velocity by the tricuspid annular plane movement during atrial contraction (TAPM AC ). Here, we investigated whether this parameter of RV operating stiffness, PRPGD AC /TAPM AC , is useful for predicting the prognosis of patients with heart failure (HF). Methods We retrospectively included 127 hospitalized patients with HF who underwent an echocardiographic examination immediately pre-discharge. The PRPGD AC /TAPM AC was measured in addition to standard echocardiographic parameters. Patients were followed until 2 years post-discharge. The endpoint was the composite of cardiac death, readmission for acute decompensation, and increased diuretic dose due to worsening HF. Results 58 patients (46%) experienced the endpoint during follow-up. Univariable and multivariable Cox regression analyses demonstrated that the PRPGD AC /TAPM AC was associated with the endpoint. In a Kaplan–Meier analysis, the event rate of the greater PRPGD AC /TAPM AC group was significantly higher than that of the lesser PRPGD AC /TAPM AC group. In a sequential Cox analysis for predicting the endpoint's occurrence, the addition of PRPGD AC /TAPM AC to the model including age, sex, NYHA functional classification, brain natriuretic peptide level, and several echocardiographic parameters including tricuspid annular plane systolic excursion significantly improved the predictive power for prognosis. Conclusion A completely noninvasive index of RV operating stiffness, PRPGD AC /TAPM AC , was useful for predicting prognoses in patients with HF, and it showed an incremental prognostic value over RV systolic function.
ISSN:0910-8327
1615-2573
DOI:10.1007/s00380-021-01960-6