Right ventricular diameter predicts all-cause mortality in heart failure with preserved ejection fraction
Left ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) phenotype in clinical practice. The aim of the study was to identify simple echocardiographic predictors of post-discharge all-cause mortality in hospitalized HF patients. Patients with acute HF (75 ± 9.8 years),...
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| Veröffentlicht in: | Internal and emergency medicine 2019-10, Vol.14 (7), p.1091-1100 |
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| creator | Parrinello, Gaspare Torres, Daniele Buscemi, Silvio Di Chiara, Tiziana Cuttitta, Francesco Cardillo, Mauro Pluchinotta, Francesca Romana Scaglione, Rosario Paterna, Salvatore Pinto, Antonio |
| description | Left ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) phenotype in clinical practice. The aim of the study was to identify simple echocardiographic predictors of post-discharge all-cause mortality in hospitalized HF patients. Patients with acute HF (75 ± 9.8 years), classified in preserved (≥ 50%) and reduced ( |
| doi_str_mv | 10.1007/s11739-019-02071-x |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2195261279</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2194439300</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-ec562cfc72f83125a206067ff9f4e8da33531047f52328f98d4593fded2eb33e3</originalsourceid><addsrcrecordid>eNp9kUlLBDEUhIMoLqN_wIMEvHhpzdLpdI4ibiAIoucQ0y9Ohl7GJK3jvzfjjAoePIQU5Kt6jxRCh5ScUkLkWaRUclUQmg8jkhaLDbRLlSSF4lW1mXXN6oKUpdxBezHOCBGionIb7XBSK1EyuYv8g3-ZJvwGfQrejq0JuPGmgwQBzwM03qaITdsW1owRcDeEZFqfPrDv8RRMSNgZ344B8LtP06UlQniDBsMMbPJDj10wX2IfbTnTRjhY3xP0dHX5eHFT3N1f316c3xWWS5EKsKJi1lnJXM0pE4aRilTSOeVKqBvDueCUlNIJxlntVN2UQnHXQMPgmXPgE3Syyp2H4XWEmHTno4W2NT0MY9SMKsEqyqTK6PEfdDaMoc_bLamy5IoTkim2omwYYgzg9Dz4zoQPTYleFqFXRehchP4qQi-y6WgdPT530PxYvn8-A3wFxPzUv0D4nf1P7Ce1k5VD</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2194439300</pqid></control><display><type>article</type><title>Right ventricular diameter predicts all-cause mortality in heart failure with preserved ejection fraction</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Parrinello, Gaspare ; Torres, Daniele ; Buscemi, Silvio ; Di Chiara, Tiziana ; Cuttitta, Francesco ; Cardillo, Mauro ; Pluchinotta, Francesca Romana ; Scaglione, Rosario ; Paterna, Salvatore ; Pinto, Antonio</creator><creatorcontrib>Parrinello, Gaspare ; Torres, Daniele ; Buscemi, Silvio ; Di Chiara, Tiziana ; Cuttitta, Francesco ; Cardillo, Mauro ; Pluchinotta, Francesca Romana ; Scaglione, Rosario ; Paterna, Salvatore ; Pinto, Antonio</creatorcontrib><description>Left ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) phenotype in clinical practice. The aim of the study was to identify simple echocardiographic predictors of post-discharge all-cause mortality in hospitalized HF patients. Patients with acute HF (75 ± 9.8 years), classified in preserved (≥ 50%) and reduced (< 50%) EF (HFpEF and HFrEF, respectively), were enrolled. The mean follow-up period was of 25.4 months. Patients definitively analyzed were 135. At multivariate Cox model, right ventricular diameter (RVd), inferior vena cava diameter (IVCd) and blood urea nitrogen (BUN) resulted to be significantly associated with all-cause mortality in HFpEF (HR 2.4,
p
= 0.04; HR 1.06,
p
= 0.02; HR 1.02,
p
= 0.01), whereas, left atrial volume (LAV) was significantly associated with mortality in HFrEF (HR 1.06,
p
= 0.006). Excluding LAV from the model, only COPD remained an independent predictor of all-cause mortality (HR 2.15,
p
= 0.04) in HFrEF. At Kaplan–Meier analysis, no differences of survival between HFrEF and HFpEF were found, however, significantly increased all-cause mortality for higher values of basal-RVd, BUN, and IVCd (log-rank
p
= 0.0065, 0.0063, 0.0005) in HFpEF, and for COPD and higher LAV (log-rank
p
= 0.0046,
p
= 0.033) in HFrEF. These data are indicative that in patients hospitalized with HF, EF is not a suitable predictor of long-term all-cause mortality, whereas, right ventricular volumetric remodeling and IVCd have a prognostic role in HFpEF as well as LAV in HFrEF. Our study suggests that besides EF, other echocardiographic parameters are helpful to optimize the phenotyping and prognostic stratification of HF.</description><identifier>ISSN: 1828-0447</identifier><identifier>EISSN: 1970-9366</identifier><identifier>DOI: 10.1007/s11739-019-02071-x</identifier><identifier>PMID: 30895427</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Aged ; Aged, 80 and over ; Chronic obstructive pulmonary disease ; Congestive heart failure ; Echocardiography - methods ; Echocardiography - statistics & numerical data ; Ejection fraction ; Female ; Health risk assessment ; Heart failure ; Heart Failure - classification ; Heart Failure - mortality ; Heart Failure - physiopathology ; Heart Ventricles - abnormalities ; Heart Ventricles - pathology ; Humans ; Im - Original ; Internal Medicine ; Italy ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Mortality ; Phenotypes ; Phenotyping ; Prognosis ; Risk Factors ; Stroke Volume - physiology ; Urea ; Ventricle ; Weights and Measures - instrumentation ; Weights and Measures - standards</subject><ispartof>Internal and emergency medicine, 2019-10, Vol.14 (7), p.1091-1100</ispartof><rights>Società Italiana di Medicina Interna (SIMI) 2019</rights><rights>Internal and Emergency Medicine is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-ec562cfc72f83125a206067ff9f4e8da33531047f52328f98d4593fded2eb33e3</citedby><cites>FETCH-LOGICAL-c375t-ec562cfc72f83125a206067ff9f4e8da33531047f52328f98d4593fded2eb33e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11739-019-02071-x$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11739-019-02071-x$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30895427$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Parrinello, Gaspare</creatorcontrib><creatorcontrib>Torres, Daniele</creatorcontrib><creatorcontrib>Buscemi, Silvio</creatorcontrib><creatorcontrib>Di Chiara, Tiziana</creatorcontrib><creatorcontrib>Cuttitta, Francesco</creatorcontrib><creatorcontrib>Cardillo, Mauro</creatorcontrib><creatorcontrib>Pluchinotta, Francesca Romana</creatorcontrib><creatorcontrib>Scaglione, Rosario</creatorcontrib><creatorcontrib>Paterna, Salvatore</creatorcontrib><creatorcontrib>Pinto, Antonio</creatorcontrib><title>Right ventricular diameter predicts all-cause mortality in heart failure with preserved ejection fraction</title><title>Internal and emergency medicine</title><addtitle>Intern Emerg Med</addtitle><addtitle>Intern Emerg Med</addtitle><description>Left ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) phenotype in clinical practice. The aim of the study was to identify simple echocardiographic predictors of post-discharge all-cause mortality in hospitalized HF patients. Patients with acute HF (75 ± 9.8 years), classified in preserved (≥ 50%) and reduced (< 50%) EF (HFpEF and HFrEF, respectively), were enrolled. The mean follow-up period was of 25.4 months. Patients definitively analyzed were 135. At multivariate Cox model, right ventricular diameter (RVd), inferior vena cava diameter (IVCd) and blood urea nitrogen (BUN) resulted to be significantly associated with all-cause mortality in HFpEF (HR 2.4,
p
= 0.04; HR 1.06,
p
= 0.02; HR 1.02,
p
= 0.01), whereas, left atrial volume (LAV) was significantly associated with mortality in HFrEF (HR 1.06,
p
= 0.006). Excluding LAV from the model, only COPD remained an independent predictor of all-cause mortality (HR 2.15,
p
= 0.04) in HFrEF. At Kaplan–Meier analysis, no differences of survival between HFrEF and HFpEF were found, however, significantly increased all-cause mortality for higher values of basal-RVd, BUN, and IVCd (log-rank
p
= 0.0065, 0.0063, 0.0005) in HFpEF, and for COPD and higher LAV (log-rank
p
= 0.0046,
p
= 0.033) in HFrEF. These data are indicative that in patients hospitalized with HF, EF is not a suitable predictor of long-term all-cause mortality, whereas, right ventricular volumetric remodeling and IVCd have a prognostic role in HFpEF as well as LAV in HFrEF. Our study suggests that besides EF, other echocardiographic parameters are helpful to optimize the phenotyping and prognostic stratification of HF.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Chronic obstructive pulmonary disease</subject><subject>Congestive heart failure</subject><subject>Echocardiography - methods</subject><subject>Echocardiography - statistics & numerical data</subject><subject>Ejection fraction</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Heart failure</subject><subject>Heart Failure - classification</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Ventricles - abnormalities</subject><subject>Heart Ventricles - pathology</subject><subject>Humans</subject><subject>Im - Original</subject><subject>Internal Medicine</subject><subject>Italy</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Phenotypes</subject><subject>Phenotyping</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Stroke Volume - physiology</subject><subject>Urea</subject><subject>Ventricle</subject><subject>Weights and Measures - instrumentation</subject><subject>Weights and Measures - standards</subject><issn>1828-0447</issn><issn>1970-9366</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUlLBDEUhIMoLqN_wIMEvHhpzdLpdI4ibiAIoucQ0y9Ohl7GJK3jvzfjjAoePIQU5Kt6jxRCh5ScUkLkWaRUclUQmg8jkhaLDbRLlSSF4lW1mXXN6oKUpdxBezHOCBGionIb7XBSK1EyuYv8g3-ZJvwGfQrejq0JuPGmgwQBzwM03qaITdsW1owRcDeEZFqfPrDv8RRMSNgZ344B8LtP06UlQniDBsMMbPJDj10wX2IfbTnTRjhY3xP0dHX5eHFT3N1f316c3xWWS5EKsKJi1lnJXM0pE4aRilTSOeVKqBvDueCUlNIJxlntVN2UQnHXQMPgmXPgE3Syyp2H4XWEmHTno4W2NT0MY9SMKsEqyqTK6PEfdDaMoc_bLamy5IoTkim2omwYYgzg9Dz4zoQPTYleFqFXRehchP4qQi-y6WgdPT530PxYvn8-A3wFxPzUv0D4nf1P7Ce1k5VD</recordid><startdate>20191001</startdate><enddate>20191001</enddate><creator>Parrinello, Gaspare</creator><creator>Torres, Daniele</creator><creator>Buscemi, Silvio</creator><creator>Di Chiara, Tiziana</creator><creator>Cuttitta, Francesco</creator><creator>Cardillo, Mauro</creator><creator>Pluchinotta, Francesca Romana</creator><creator>Scaglione, Rosario</creator><creator>Paterna, Salvatore</creator><creator>Pinto, Antonio</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20191001</creationdate><title>Right ventricular diameter predicts all-cause mortality in heart failure with preserved ejection fraction</title><author>Parrinello, Gaspare ; Torres, Daniele ; Buscemi, Silvio ; Di Chiara, Tiziana ; Cuttitta, Francesco ; Cardillo, Mauro ; Pluchinotta, Francesca Romana ; Scaglione, Rosario ; Paterna, Salvatore ; Pinto, Antonio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-ec562cfc72f83125a206067ff9f4e8da33531047f52328f98d4593fded2eb33e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Chronic obstructive pulmonary disease</topic><topic>Congestive heart failure</topic><topic>Echocardiography - methods</topic><topic>Echocardiography - statistics & numerical data</topic><topic>Ejection fraction</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Heart failure</topic><topic>Heart Failure - classification</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Ventricles - abnormalities</topic><topic>Heart Ventricles - pathology</topic><topic>Humans</topic><topic>Im - Original</topic><topic>Internal Medicine</topic><topic>Italy</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Phenotypes</topic><topic>Phenotyping</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Stroke Volume - physiology</topic><topic>Urea</topic><topic>Ventricle</topic><topic>Weights and Measures - instrumentation</topic><topic>Weights and Measures - standards</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Parrinello, Gaspare</creatorcontrib><creatorcontrib>Torres, Daniele</creatorcontrib><creatorcontrib>Buscemi, Silvio</creatorcontrib><creatorcontrib>Di Chiara, Tiziana</creatorcontrib><creatorcontrib>Cuttitta, Francesco</creatorcontrib><creatorcontrib>Cardillo, Mauro</creatorcontrib><creatorcontrib>Pluchinotta, Francesca Romana</creatorcontrib><creatorcontrib>Scaglione, Rosario</creatorcontrib><creatorcontrib>Paterna, Salvatore</creatorcontrib><creatorcontrib>Pinto, Antonio</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Internal and emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Parrinello, Gaspare</au><au>Torres, Daniele</au><au>Buscemi, Silvio</au><au>Di Chiara, Tiziana</au><au>Cuttitta, Francesco</au><au>Cardillo, Mauro</au><au>Pluchinotta, Francesca Romana</au><au>Scaglione, Rosario</au><au>Paterna, Salvatore</au><au>Pinto, Antonio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Right ventricular diameter predicts all-cause mortality in heart failure with preserved ejection fraction</atitle><jtitle>Internal and emergency medicine</jtitle><stitle>Intern Emerg Med</stitle><addtitle>Intern Emerg Med</addtitle><date>2019-10-01</date><risdate>2019</risdate><volume>14</volume><issue>7</issue><spage>1091</spage><epage>1100</epage><pages>1091-1100</pages><issn>1828-0447</issn><eissn>1970-9366</eissn><abstract>Left ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) phenotype in clinical practice. The aim of the study was to identify simple echocardiographic predictors of post-discharge all-cause mortality in hospitalized HF patients. Patients with acute HF (75 ± 9.8 years), classified in preserved (≥ 50%) and reduced (< 50%) EF (HFpEF and HFrEF, respectively), were enrolled. The mean follow-up period was of 25.4 months. Patients definitively analyzed were 135. At multivariate Cox model, right ventricular diameter (RVd), inferior vena cava diameter (IVCd) and blood urea nitrogen (BUN) resulted to be significantly associated with all-cause mortality in HFpEF (HR 2.4,
p
= 0.04; HR 1.06,
p
= 0.02; HR 1.02,
p
= 0.01), whereas, left atrial volume (LAV) was significantly associated with mortality in HFrEF (HR 1.06,
p
= 0.006). Excluding LAV from the model, only COPD remained an independent predictor of all-cause mortality (HR 2.15,
p
= 0.04) in HFrEF. At Kaplan–Meier analysis, no differences of survival between HFrEF and HFpEF were found, however, significantly increased all-cause mortality for higher values of basal-RVd, BUN, and IVCd (log-rank
p
= 0.0065, 0.0063, 0.0005) in HFpEF, and for COPD and higher LAV (log-rank
p
= 0.0046,
p
= 0.033) in HFrEF. These data are indicative that in patients hospitalized with HF, EF is not a suitable predictor of long-term all-cause mortality, whereas, right ventricular volumetric remodeling and IVCd have a prognostic role in HFpEF as well as LAV in HFrEF. Our study suggests that besides EF, other echocardiographic parameters are helpful to optimize the phenotyping and prognostic stratification of HF.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>30895427</pmid><doi>10.1007/s11739-019-02071-x</doi><tpages>10</tpages></addata></record> |
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| ispartof | Internal and emergency medicine, 2019-10, Vol.14 (7), p.1091-1100 |
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| subjects | Aged Aged, 80 and over Chronic obstructive pulmonary disease Congestive heart failure Echocardiography - methods Echocardiography - statistics & numerical data Ejection fraction Female Health risk assessment Heart failure Heart Failure - classification Heart Failure - mortality Heart Failure - physiopathology Heart Ventricles - abnormalities Heart Ventricles - pathology Humans Im - Original Internal Medicine Italy Male Medicine Medicine & Public Health Middle Aged Mortality Phenotypes Phenotyping Prognosis Risk Factors Stroke Volume - physiology Urea Ventricle Weights and Measures - instrumentation Weights and Measures - standards |
| title | Right ventricular diameter predicts all-cause mortality in heart failure with preserved ejection fraction |
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