Prognostic Importance of Right Ventricular-Vascular Uncoupling in Acute Decompensated Heart Failure With Preserved Ejection Fraction
Recent accumulating evidence reveals that the right ventricular (RV)-pulmonary artery (PA) uncoupling is associated with poor outcome in patients with heart failure (HF), RV dysfunction, and pulmonary hypertension. However, the prognostic utility of RV-PA uncoupling in HF with preserved ejection fra...
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| Veröffentlicht in: | Circulation. Cardiovascular imaging 2020-11, Vol.13 (11), p.e011430-e011430 |
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| creator | Nakagawa, Akito Yasumura, Yoshio Yoshida, Chikako Okumura, Takahiro Tateishi, Jun Yoshida, Junichi Abe, Haruhiko Tamaki, Shunsuke Yano, Masamichi Hayashi, Takaharu Nakagawa, Yusuke Yamada, Takahisa Nakatani, Daisaku Hikoso, Shungo Sakata, Yasushi |
| description | Recent accumulating evidence reveals that the right ventricular (RV)-pulmonary artery (PA) uncoupling is associated with poor outcome in patients with heart failure (HF), RV dysfunction, and pulmonary hypertension. However, the prognostic utility of RV-PA uncoupling in HF with preserved ejection fraction (HFpEF) remains elusive. In this study, we aim to investigate the associations of RV-PA uncoupling with outcomes of HFpEF inpatients.
We prospectively studied 655 patients, registered in PURSUIT-HFpEF (The Prospective Multicenter Obervational Study of Patients with Heart Failure with Preserved Ejection Fraction), a multicenter observational study of Japanese HFpEF inpatients. We assigned registered patients based on the determined value of tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio that can predict primary outcome as an indicator of RV-PA uncoupling.
Univariable Cox regression testing revealed that RV-PA uncoupling was associated with the primary endpoint of all-cause death, HF rehospitalization, and cerebrovascular events (hazard ratio [HR] 1.77 [95% CI, 1.34-2.32], |
| doi_str_mv | 10.1161/CIRCIMAGING.120.011430 |
| format | Article |
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We prospectively studied 655 patients, registered in PURSUIT-HFpEF (The Prospective Multicenter Obervational Study of Patients with Heart Failure with Preserved Ejection Fraction), a multicenter observational study of Japanese HFpEF inpatients. We assigned registered patients based on the determined value of tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio that can predict primary outcome as an indicator of RV-PA uncoupling.
Univariable Cox regression testing revealed that RV-PA uncoupling was associated with the primary endpoint of all-cause death, HF rehospitalization, and cerebrovascular events (hazard ratio [HR] 1.77 [95% CI, 1.34-2.32],
<0.0001) and the secondary endpoints of all-cause death and HF rehospitalization (HR 2.75 [95% CI, 1.77-4.33],
<0.0001, HR 1.63 [95% CI, 1.18-2.26],
=0.0036, respectively). Multivariable analysis also showed that RV-PA uncoupling was significantly associated with primary endpoint and all-cause death independent of age, sex, atrial fibrillation, renal dysfunction, elevated E/e', and elevated NT-proBNP (N-terminal pro-B-type natriuretic peptide) (HR 1.38 [95% CI, 1.01-1.88],
=0.0413, HR 1.85 [95% CI, 1.14-3.01],
=0.0129, respectively).
Prospective study of a hospitalized cohort revealed that RV-PA uncoupling was independently associated with adverse outcomes in acute decompensated patients with HFpEF. Registration: URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000024414. Unique identifier: UMIN000021831.</description><identifier>ISSN: 1942-0080</identifier><identifier>ISSN: 1941-9651</identifier><identifier>EISSN: 1942-0080</identifier><identifier>DOI: 10.1161/CIRCIMAGING.120.011430</identifier><identifier>PMID: 33198494</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Aged ; Aged, 80 and over ; Arterial Pressure ; Female ; Heart Failure - diagnostic imaging ; Heart Failure - mortality ; Heart Failure - physiopathology ; Heart Failure - therapy ; Humans ; Japan ; Male ; Patient Readmission ; Prognosis ; Prospective Studies ; Pulmonary Artery - physiopathology ; Risk Assessment ; Risk Factors ; Stroke Volume ; Tricuspid Valve - physiopathology ; Ventricular Function, Left ; Ventricular Function, Right</subject><ispartof>Circulation. Cardiovascular imaging, 2020-11, Vol.13 (11), p.e011430-e011430</ispartof><rights>American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4046-23e81a8be5b86615a2fb327d52b5f695df00da0ce77acdbafc02677c95250cb03</citedby><cites>FETCH-LOGICAL-c4046-23e81a8be5b86615a2fb327d52b5f695df00da0ce77acdbafc02677c95250cb03</cites><orcidid>0000-0003-1637-4536 ; 0000-0001-5642-3836 ; 0000-0001-8276-1505</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33198494$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakagawa, Akito</creatorcontrib><creatorcontrib>Yasumura, Yoshio</creatorcontrib><creatorcontrib>Yoshida, Chikako</creatorcontrib><creatorcontrib>Okumura, Takahiro</creatorcontrib><creatorcontrib>Tateishi, Jun</creatorcontrib><creatorcontrib>Yoshida, Junichi</creatorcontrib><creatorcontrib>Abe, Haruhiko</creatorcontrib><creatorcontrib>Tamaki, Shunsuke</creatorcontrib><creatorcontrib>Yano, Masamichi</creatorcontrib><creatorcontrib>Hayashi, Takaharu</creatorcontrib><creatorcontrib>Nakagawa, Yusuke</creatorcontrib><creatorcontrib>Yamada, Takahisa</creatorcontrib><creatorcontrib>Nakatani, Daisaku</creatorcontrib><creatorcontrib>Hikoso, Shungo</creatorcontrib><creatorcontrib>Sakata, Yasushi</creatorcontrib><creatorcontrib>on behalf of Osaka CardioVascular Conference (OCVC)-Heart Failure investigators</creatorcontrib><title>Prognostic Importance of Right Ventricular-Vascular Uncoupling in Acute Decompensated Heart Failure With Preserved Ejection Fraction</title><title>Circulation. Cardiovascular imaging</title><addtitle>Circ Cardiovasc Imaging</addtitle><description>Recent accumulating evidence reveals that the right ventricular (RV)-pulmonary artery (PA) uncoupling is associated with poor outcome in patients with heart failure (HF), RV dysfunction, and pulmonary hypertension. However, the prognostic utility of RV-PA uncoupling in HF with preserved ejection fraction (HFpEF) remains elusive. In this study, we aim to investigate the associations of RV-PA uncoupling with outcomes of HFpEF inpatients.
We prospectively studied 655 patients, registered in PURSUIT-HFpEF (The Prospective Multicenter Obervational Study of Patients with Heart Failure with Preserved Ejection Fraction), a multicenter observational study of Japanese HFpEF inpatients. We assigned registered patients based on the determined value of tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio that can predict primary outcome as an indicator of RV-PA uncoupling.
Univariable Cox regression testing revealed that RV-PA uncoupling was associated with the primary endpoint of all-cause death, HF rehospitalization, and cerebrovascular events (hazard ratio [HR] 1.77 [95% CI, 1.34-2.32],
<0.0001) and the secondary endpoints of all-cause death and HF rehospitalization (HR 2.75 [95% CI, 1.77-4.33],
<0.0001, HR 1.63 [95% CI, 1.18-2.26],
=0.0036, respectively). Multivariable analysis also showed that RV-PA uncoupling was significantly associated with primary endpoint and all-cause death independent of age, sex, atrial fibrillation, renal dysfunction, elevated E/e', and elevated NT-proBNP (N-terminal pro-B-type natriuretic peptide) (HR 1.38 [95% CI, 1.01-1.88],
=0.0413, HR 1.85 [95% CI, 1.14-3.01],
=0.0129, respectively).
Prospective study of a hospitalized cohort revealed that RV-PA uncoupling was independently associated with adverse outcomes in acute decompensated patients with HFpEF. Registration: URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000024414. Unique identifier: UMIN000021831.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Arterial Pressure</subject><subject>Female</subject><subject>Heart Failure - diagnostic imaging</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Failure - therapy</subject><subject>Humans</subject><subject>Japan</subject><subject>Male</subject><subject>Patient Readmission</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Pulmonary Artery - physiopathology</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Stroke Volume</subject><subject>Tricuspid Valve - physiopathology</subject><subject>Ventricular Function, Left</subject><subject>Ventricular Function, Right</subject><issn>1942-0080</issn><issn>1941-9651</issn><issn>1942-0080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkU9v1DAQxSMEoqXwFSofe8ky_hMnOa623d1IBaqKlqPlOJNdlyQOttOKOx-cbLegnuZJ894baX5Jck5hQamkn1fV7ar6stxUXzcLymABlAoOb5JTWgqWAhTw9pU-ST6E8AAgOWTF--SEc1oWohSnyZ8b73aDC9EaUvWj81EPBolrya3d7SO5xyF6a6ZO-_Reh2dB7gbjprGzw47YgSzNFJFconH9iEPQERuyRe0jWWvbTR7JDxv35MZjQP84L68e0ETrBrL2-ll8TN61ugv46WWeJXfrq--rbXr9bVOtltepESBkyjgWVBc1ZnUhJc00a2vO8iZjddbKMmtagEaDwTzXpql1a4DJPDdlxjIwNfCz5OLYO3r3a8IQVW-Dwa7TA7opKCYk5SUv2MEqj1bjXQgeWzV622v_W1FQBwLqFQE1E1BHAnPw_OXGVPfY_I_9e_lsEEfDk-si-vCzm57Qqz3qLu7nFs5zURYpAzY3AsAM8ADuL_qSlK4</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Nakagawa, Akito</creator><creator>Yasumura, Yoshio</creator><creator>Yoshida, Chikako</creator><creator>Okumura, Takahiro</creator><creator>Tateishi, Jun</creator><creator>Yoshida, Junichi</creator><creator>Abe, Haruhiko</creator><creator>Tamaki, Shunsuke</creator><creator>Yano, Masamichi</creator><creator>Hayashi, Takaharu</creator><creator>Nakagawa, Yusuke</creator><creator>Yamada, Takahisa</creator><creator>Nakatani, Daisaku</creator><creator>Hikoso, Shungo</creator><creator>Sakata, Yasushi</creator><general>American Heart Association, Inc</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>7X8</scope><orcidid>https://orcid.org/0000-0003-1637-4536</orcidid><orcidid>https://orcid.org/0000-0001-5642-3836</orcidid><orcidid>https://orcid.org/0000-0001-8276-1505</orcidid></search><sort><creationdate>20201101</creationdate><title>Prognostic Importance of Right Ventricular-Vascular Uncoupling in Acute Decompensated Heart Failure With Preserved Ejection Fraction</title><author>Nakagawa, Akito ; Yasumura, Yoshio ; Yoshida, Chikako ; Okumura, Takahiro ; Tateishi, Jun ; Yoshida, Junichi ; Abe, Haruhiko ; Tamaki, Shunsuke ; Yano, Masamichi ; Hayashi, Takaharu ; Nakagawa, Yusuke ; Yamada, Takahisa ; Nakatani, Daisaku ; Hikoso, Shungo ; Sakata, Yasushi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4046-23e81a8be5b86615a2fb327d52b5f695df00da0ce77acdbafc02677c95250cb03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Arterial Pressure</topic><topic>Female</topic><topic>Heart Failure - diagnostic imaging</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Failure - therapy</topic><topic>Humans</topic><topic>Japan</topic><topic>Male</topic><topic>Patient Readmission</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Pulmonary Artery - physiopathology</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Stroke Volume</topic><topic>Tricuspid Valve - physiopathology</topic><topic>Ventricular Function, Left</topic><topic>Ventricular Function, Right</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakagawa, Akito</creatorcontrib><creatorcontrib>Yasumura, Yoshio</creatorcontrib><creatorcontrib>Yoshida, Chikako</creatorcontrib><creatorcontrib>Okumura, Takahiro</creatorcontrib><creatorcontrib>Tateishi, Jun</creatorcontrib><creatorcontrib>Yoshida, Junichi</creatorcontrib><creatorcontrib>Abe, Haruhiko</creatorcontrib><creatorcontrib>Tamaki, Shunsuke</creatorcontrib><creatorcontrib>Yano, Masamichi</creatorcontrib><creatorcontrib>Hayashi, Takaharu</creatorcontrib><creatorcontrib>Nakagawa, Yusuke</creatorcontrib><creatorcontrib>Yamada, Takahisa</creatorcontrib><creatorcontrib>Nakatani, Daisaku</creatorcontrib><creatorcontrib>Hikoso, Shungo</creatorcontrib><creatorcontrib>Sakata, Yasushi</creatorcontrib><creatorcontrib>on behalf of Osaka CardioVascular Conference (OCVC)-Heart Failure investigators</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakagawa, Akito</au><au>Yasumura, Yoshio</au><au>Yoshida, Chikako</au><au>Okumura, Takahiro</au><au>Tateishi, Jun</au><au>Yoshida, Junichi</au><au>Abe, Haruhiko</au><au>Tamaki, Shunsuke</au><au>Yano, Masamichi</au><au>Hayashi, Takaharu</au><au>Nakagawa, Yusuke</au><au>Yamada, Takahisa</au><au>Nakatani, Daisaku</au><au>Hikoso, Shungo</au><au>Sakata, Yasushi</au><aucorp>on behalf of Osaka CardioVascular Conference (OCVC)-Heart Failure investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic Importance of Right Ventricular-Vascular Uncoupling in Acute Decompensated Heart Failure With Preserved Ejection Fraction</atitle><jtitle>Circulation. Cardiovascular imaging</jtitle><addtitle>Circ Cardiovasc Imaging</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>13</volume><issue>11</issue><spage>e011430</spage><epage>e011430</epage><pages>e011430-e011430</pages><issn>1942-0080</issn><issn>1941-9651</issn><eissn>1942-0080</eissn><abstract>Recent accumulating evidence reveals that the right ventricular (RV)-pulmonary artery (PA) uncoupling is associated with poor outcome in patients with heart failure (HF), RV dysfunction, and pulmonary hypertension. However, the prognostic utility of RV-PA uncoupling in HF with preserved ejection fraction (HFpEF) remains elusive. In this study, we aim to investigate the associations of RV-PA uncoupling with outcomes of HFpEF inpatients.
We prospectively studied 655 patients, registered in PURSUIT-HFpEF (The Prospective Multicenter Obervational Study of Patients with Heart Failure with Preserved Ejection Fraction), a multicenter observational study of Japanese HFpEF inpatients. We assigned registered patients based on the determined value of tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio that can predict primary outcome as an indicator of RV-PA uncoupling.
Univariable Cox regression testing revealed that RV-PA uncoupling was associated with the primary endpoint of all-cause death, HF rehospitalization, and cerebrovascular events (hazard ratio [HR] 1.77 [95% CI, 1.34-2.32],
<0.0001) and the secondary endpoints of all-cause death and HF rehospitalization (HR 2.75 [95% CI, 1.77-4.33],
<0.0001, HR 1.63 [95% CI, 1.18-2.26],
=0.0036, respectively). Multivariable analysis also showed that RV-PA uncoupling was significantly associated with primary endpoint and all-cause death independent of age, sex, atrial fibrillation, renal dysfunction, elevated E/e', and elevated NT-proBNP (N-terminal pro-B-type natriuretic peptide) (HR 1.38 [95% CI, 1.01-1.88],
=0.0413, HR 1.85 [95% CI, 1.14-3.01],
=0.0129, respectively).
Prospective study of a hospitalized cohort revealed that RV-PA uncoupling was independently associated with adverse outcomes in acute decompensated patients with HFpEF. Registration: URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000024414. Unique identifier: UMIN000021831.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>33198494</pmid><doi>10.1161/CIRCIMAGING.120.011430</doi><orcidid>https://orcid.org/0000-0003-1637-4536</orcidid><orcidid>https://orcid.org/0000-0001-5642-3836</orcidid><orcidid>https://orcid.org/0000-0001-8276-1505</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1942-0080 |
| ispartof | Circulation. Cardiovascular imaging, 2020-11, Vol.13 (11), p.e011430-e011430 |
| issn | 1942-0080 1941-9651 1942-0080 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2461393820 |
| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Aged, 80 and over Arterial Pressure Female Heart Failure - diagnostic imaging Heart Failure - mortality Heart Failure - physiopathology Heart Failure - therapy Humans Japan Male Patient Readmission Prognosis Prospective Studies Pulmonary Artery - physiopathology Risk Assessment Risk Factors Stroke Volume Tricuspid Valve - physiopathology Ventricular Function, Left Ventricular Function, Right |
| title | Prognostic Importance of Right Ventricular-Vascular Uncoupling in Acute Decompensated Heart Failure With Preserved Ejection Fraction |
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