Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Elevated pulmonary arterial elastance and right ventricular uncoupling are associated with greater mortality in advanced heart failure

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Survival in patients with scintigraphic evidence of pulmonary thromboembolism 12 weeks after double lung transplantation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Felodipine and renal function in lung transplantation: A randomized placebo-controlled trial

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Interplay of pump design elements and bleeding predilection-Mechanisms for a forward momentum

    Publikation: Bidrag til tidsskriftLederForskningpeer review

  4. Exercise cardiovascular magnetic resonance imaging allows differentiation of low-risk pulmonary arterial hypertension

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. An ISHLT consensus document for prevention and management strategies for mechanical circulatory support infection

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Cardiac Troponin I and Incident Stroke in European Cohorts: Insights From the BiomarCaRE Project

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Association between antecedent blood pressure, hypertension-mediated organ damage and cardiovascular outcome

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Does Estimated Pulse Wave Velocity Add Prognostic Information? MORGAM Prospective Cohort Project

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Temporal relations between atrial fibrillation and ischaemic stroke and their prognostic impact on mortality

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

BACKGROUND: The objectives of this study were to describe right ventricular-pulmonary arterial elastance coupling hemodynamic phenotypes and their frequency in patients with advanced heart failure and to evaluate the association of elastance-based indices with all-cause mortality, cardiac transplantation, and left ventricular assist device therapy.

METHODS: This study included 175 patients with heart failure undergoing right heart catheterization to evaluate candidacy for advanced therapies and 21 healthy controls. We modified a single-beat approach to elastance to account for the magnitude of pulmonary arterial pressure and estimated right ventricular end-systolic elastance (Ees), pulmonary arterial elastance (Ea), and the Ees:Ea ratio. We defined elevated pulmonary arterial load as an Ea > 0.5 mm Hg/ml, and ventriculo-arterial uncoupling as an Ees:Ea < 0.8. We evaluated associations between Ees, Ea, and Ees:Ea with all-cause mortality and composite event-free survival using multivariable Cox proportional-hazard models, adjusted for age and sex.

RESULTS: All 21 controls had Ea ≤ 0.5 mm Hg/ml and Ees:Ea ≥ 0.8. Of 175 patients with heart failure, 63% had Ea > 0.5 mm Hg/ml. Ees:Ea was lower in patients than in controls (p < 0.001), and 47% of the patients demonstrated Ees:Ea < 0.8, including 8% with normal Ea. In median follow-up of 2.2 (0.8-4.6) years, 53 died, 37 received cardiac transplantation, and 33 received a left ventricular assist device. By multivariable analysis, Ea (hazard ratios [HR]: 2.01, 95% CI 1.18-3.41) and Ees:Ea (HR: 0.46, 95% CI: 0.26-0.82) were independently associated with mortality, whereas Ees was not.

CONCLUSIONS: Right ventricular-pulmonary vascular coupling is frequently impaired in heart failure and associated with greater mortality. Elevated pulmonary arterial elastance is associated with greater mortality even when coupling is preserved.

OriginalsprogEngelsk
TidsskriftThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
Vol/bind39
Udgave nummer7
Sider (fra-til)657-665
Antal sider9
ISSN1053-2498
DOI
StatusUdgivet - jul. 2020

Bibliografisk note

Copyright © 2020 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

ID: 59691321