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Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart Failure

Publikation: Bidrag til tidsskriftReviewpeer review

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AIM: To test if the newly described haemodynamic variable, aortic pulsatility index (API), predicts long-term prognosis in advanced heart failure (HF).

METHODS: A single-centre study on 453 HF patients (median age: 51 years; left ventricular ejection fraction [LVEF]: 19% ± 9%) referred for right heart catheterisation. API was calculated as pulse pressure/pulmonary capillary wedge pressure.

RESULTS: Log(API) correlated significantly with central venous pressure (CVP; p<0.001) and cardiac index (p<0.001) in univariable regression analysis. CVP remained associated with log(API) in a multivariable analysis including cardiac index, heart rate, log(NT-proBNP [N-terminal proB-type natriuretic peptide]), LVEF, New York Heart Association (NYHA) class III or IV and sex (p=0.01). In univariable Cox models, log(API) was a significant predictor of freedom from the combined endpoint of death, left ventricular assist device implantation, total artificial heart implantation or heart transplantation (HR 0.33; (95% CI [0.22-0.49]); p<0.001) and all-cause mortality (HR 0.56 (95% CI [0.35-0.90]); p=0.015). After adjusting for age, sex, NYHA class III or IV and estimated glomerular filtration rate in multivariable Cox models, log(API) remained a significant predictor for the combined endpoint (HR 0.33; 95% CI [0.20-0.56]; p<0.001) and all-cause mortality (HR 0.49; 95% CI [0.26-0.96]; p=0.034).

CONCLUSION: API was strongly associated with right-sided filling pressure and independently predicted freedom from the combined endpoint and all-cause mortality.

OriginalsprogEngelsk
TidsskriftJournal of Cardiac Failure
Vol/bind8
Sider (fra-til)e18
ISSN2057-7540
DOI
StatusUdgivet - jan. 2022

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