Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure
OBJECTIVES We sought a better understanding of the coupling between right ventricular ejection fraction (RVEF) and pulmonary artery pressure (PAP), as it might improve the accuracy of the prognostic stratification of patients with heart failure. BACKGROUND Despite the long-standing view that systoli...
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| Veröffentlicht in: | Journal of the American College of Cardiology 2001-01, Vol.37 (1), p.183-188 |
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| container_title | Journal of the American College of Cardiology |
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| creator | Ghio, Stefano Gavazzi, Antonello Campana, Carlo Inserra, Corinna Klersy, Catherine Sebastiani, Roberta Arbustini, Eloisa Recusani, Franco Tavazzi, Luigi |
| description | OBJECTIVES
We sought a better understanding of the coupling between right ventricular ejection fraction (RVEF) and pulmonary artery pressure (PAP), as it might improve the accuracy of the prognostic stratification of patients with heart failure.
BACKGROUND
Despite the long-standing view that systolic function of the right ventricle (RV) is almost exclusively dependent on the afterload that this cardiac chamber must confront, recent studies claim that RV function is an independent prognostic factor in patients with chronic heart failure.
METHODS
Right heart catheterization was performed in 377 consecutive patients with heart failure.
RESULTS
During a median follow-up period of 17 ± 9 months, 105 patients died and 35 underwent urgent heart transplantation. Pulmonary artery pressure and thermodilution-derived RVEF were inversely related (r = 0.66, p < 0.001). However, on Cox multivariate survival analysis, no interaction between such variables was found, and both turned out to be independent prognostic predictors (p < 0.001). It was found that RVEF was preserved in some patients with pulmonary hypertension, and that the prognosis of these patients was similar to that of the patients with normal PAP. In contrast, when PAP was normal, reduced RV function did not carry an additional risk.
CONCLUSIONS
These observations emphasize the necessity of combining the right heart hemodynamic variables with a functional evaluation of the RV when trying to define the individual risk of patients with heart failure. |
| doi_str_mv | 10.1016/S0735-1097(00)01102-5 |
| format | Article |
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We sought a better understanding of the coupling between right ventricular ejection fraction (RVEF) and pulmonary artery pressure (PAP), as it might improve the accuracy of the prognostic stratification of patients with heart failure.
BACKGROUND
Despite the long-standing view that systolic function of the right ventricle (RV) is almost exclusively dependent on the afterload that this cardiac chamber must confront, recent studies claim that RV function is an independent prognostic factor in patients with chronic heart failure.
METHODS
Right heart catheterization was performed in 377 consecutive patients with heart failure.
RESULTS
During a median follow-up period of 17 ± 9 months, 105 patients died and 35 underwent urgent heart transplantation. Pulmonary artery pressure and thermodilution-derived RVEF were inversely related (r = 0.66, p < 0.001). However, on Cox multivariate survival analysis, no interaction between such variables was found, and both turned out to be independent prognostic predictors (p < 0.001). It was found that RVEF was preserved in some patients with pulmonary hypertension, and that the prognosis of these patients was similar to that of the patients with normal PAP. In contrast, when PAP was normal, reduced RV function did not carry an additional risk.
CONCLUSIONS
These observations emphasize the necessity of combining the right heart hemodynamic variables with a functional evaluation of the RV when trying to define the individual risk of patients with heart failure.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(00)01102-5</identifier><identifier>PMID: 11153735</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Biological and medical sciences ; Cardiology. Vascular system ; Chronic Disease ; Female ; Heart ; Heart Failure - diagnosis ; Heart Failure - physiopathology ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Hypertension, Pulmonary - diagnosis ; Hypertension, Pulmonary - physiopathology ; Male ; Medical sciences ; Middle Aged ; Prognosis ; Pulmonary Wedge Pressure - physiology ; Stroke Volume - physiology ; Systole - physiology ; Ventricular Function, Right - physiology</subject><ispartof>Journal of the American College of Cardiology, 2001-01, Vol.37 (1), p.183-188</ispartof><rights>2001 American College of Cardiology</rights><rights>2001 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c522t-88e714bdea34a61489de9776a9981237715e60e7588a8dae2defc62095a1143</citedby><cites>FETCH-LOGICAL-c522t-88e714bdea34a61489de9776a9981237715e60e7588a8dae2defc62095a1143</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0735109700011025$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,4036,4037,23909,23910,25118,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=847292$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11153735$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ghio, Stefano</creatorcontrib><creatorcontrib>Gavazzi, Antonello</creatorcontrib><creatorcontrib>Campana, Carlo</creatorcontrib><creatorcontrib>Inserra, Corinna</creatorcontrib><creatorcontrib>Klersy, Catherine</creatorcontrib><creatorcontrib>Sebastiani, Roberta</creatorcontrib><creatorcontrib>Arbustini, Eloisa</creatorcontrib><creatorcontrib>Recusani, Franco</creatorcontrib><creatorcontrib>Tavazzi, Luigi</creatorcontrib><title>Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>OBJECTIVES
We sought a better understanding of the coupling between right ventricular ejection fraction (RVEF) and pulmonary artery pressure (PAP), as it might improve the accuracy of the prognostic stratification of patients with heart failure.
BACKGROUND
Despite the long-standing view that systolic function of the right ventricle (RV) is almost exclusively dependent on the afterload that this cardiac chamber must confront, recent studies claim that RV function is an independent prognostic factor in patients with chronic heart failure.
METHODS
Right heart catheterization was performed in 377 consecutive patients with heart failure.
RESULTS
During a median follow-up period of 17 ± 9 months, 105 patients died and 35 underwent urgent heart transplantation. Pulmonary artery pressure and thermodilution-derived RVEF were inversely related (r = 0.66, p < 0.001). However, on Cox multivariate survival analysis, no interaction between such variables was found, and both turned out to be independent prognostic predictors (p < 0.001). It was found that RVEF was preserved in some patients with pulmonary hypertension, and that the prognosis of these patients was similar to that of the patients with normal PAP. In contrast, when PAP was normal, reduced RV function did not carry an additional risk.
CONCLUSIONS
These observations emphasize the necessity of combining the right heart hemodynamic variables with a functional evaluation of the RV when trying to define the individual risk of patients with heart failure.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Chronic Disease</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Failure - diagnosis</subject><subject>Heart Failure - physiopathology</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - diagnosis</subject><subject>Hypertension, Pulmonary - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Prognosis</subject><subject>Pulmonary Wedge Pressure - physiology</subject><subject>Stroke Volume - physiology</subject><subject>Systole - physiology</subject><subject>Ventricular Function, Right - physiology</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1u1DAUhS0EokPhEUCWkBAsAr5JHDsrhCp-KlViUfbWrX3TMcrYwXYG9UF4X9yZUVmy8V34O8e-5zD2EsR7EDB8uBaqkw2IUb0V4p0AEG0jH7ENSKmbTo7qMds8IGfsWc4_hRCDhvEpOwMA2dXLDftzGRwtVI9QOAbH0Tlf_J74kuJtiLl4y_c4r8TjxJO_3Ra-r2zydp0x8XyXS5wrM63BFh_DwWRZ510MmO44pkJ1LIlyXhNxH_iCxVeHzH_7suV2m2Ko-i1VlE_o54o9Z08mnDO9OM1zdv3l84-Lb83V96-XF5-uGivbtjRak4L-xhF2PQ7Q69HRqNSA46ih7ZQCSYMgJbVG7ZBaR5MdWjFKBOi7c_bm6FpX_bVSLmbns6V5xkBxzUYJqaQCVUF5BG2KOSeazJL8rq5nQJj7NsyhDXMftRHCHNowsupenR5Yb3bk_qlO8Vfg9QnAbHGeEgbr8wOne9WObaU-HimqUew9JZNtTdCS84lsMS76_3zkL6Yoqf0</recordid><startdate>200101</startdate><enddate>200101</enddate><creator>Ghio, Stefano</creator><creator>Gavazzi, Antonello</creator><creator>Campana, Carlo</creator><creator>Inserra, Corinna</creator><creator>Klersy, Catherine</creator><creator>Sebastiani, Roberta</creator><creator>Arbustini, Eloisa</creator><creator>Recusani, Franco</creator><creator>Tavazzi, Luigi</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><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></search><sort><creationdate>200101</creationdate><title>Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure</title><author>Ghio, Stefano ; Gavazzi, Antonello ; Campana, Carlo ; Inserra, Corinna ; Klersy, Catherine ; Sebastiani, Roberta ; Arbustini, Eloisa ; Recusani, Franco ; Tavazzi, Luigi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c522t-88e714bdea34a61489de9776a9981237715e60e7588a8dae2defc62095a1143</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Chronic Disease</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Failure - diagnosis</topic><topic>Heart Failure - physiopathology</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - diagnosis</topic><topic>Hypertension, Pulmonary - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Prognosis</topic><topic>Pulmonary Wedge Pressure - physiology</topic><topic>Stroke Volume - physiology</topic><topic>Systole - physiology</topic><topic>Ventricular Function, Right - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ghio, Stefano</creatorcontrib><creatorcontrib>Gavazzi, Antonello</creatorcontrib><creatorcontrib>Campana, Carlo</creatorcontrib><creatorcontrib>Inserra, Corinna</creatorcontrib><creatorcontrib>Klersy, Catherine</creatorcontrib><creatorcontrib>Sebastiani, Roberta</creatorcontrib><creatorcontrib>Arbustini, Eloisa</creatorcontrib><creatorcontrib>Recusani, Franco</creatorcontrib><creatorcontrib>Tavazzi, Luigi</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><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>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ghio, Stefano</au><au>Gavazzi, Antonello</au><au>Campana, Carlo</au><au>Inserra, Corinna</au><au>Klersy, Catherine</au><au>Sebastiani, Roberta</au><au>Arbustini, Eloisa</au><au>Recusani, Franco</au><au>Tavazzi, Luigi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2001-01</date><risdate>2001</risdate><volume>37</volume><issue>1</issue><spage>183</spage><epage>188</epage><pages>183-188</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>OBJECTIVES
We sought a better understanding of the coupling between right ventricular ejection fraction (RVEF) and pulmonary artery pressure (PAP), as it might improve the accuracy of the prognostic stratification of patients with heart failure.
BACKGROUND
Despite the long-standing view that systolic function of the right ventricle (RV) is almost exclusively dependent on the afterload that this cardiac chamber must confront, recent studies claim that RV function is an independent prognostic factor in patients with chronic heart failure.
METHODS
Right heart catheterization was performed in 377 consecutive patients with heart failure.
RESULTS
During a median follow-up period of 17 ± 9 months, 105 patients died and 35 underwent urgent heart transplantation. Pulmonary artery pressure and thermodilution-derived RVEF were inversely related (r = 0.66, p < 0.001). However, on Cox multivariate survival analysis, no interaction between such variables was found, and both turned out to be independent prognostic predictors (p < 0.001). It was found that RVEF was preserved in some patients with pulmonary hypertension, and that the prognosis of these patients was similar to that of the patients with normal PAP. In contrast, when PAP was normal, reduced RV function did not carry an additional risk.
CONCLUSIONS
These observations emphasize the necessity of combining the right heart hemodynamic variables with a functional evaluation of the RV when trying to define the individual risk of patients with heart failure.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11153735</pmid><doi>10.1016/S0735-1097(00)01102-5</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of the American College of Cardiology, 2001-01, Vol.37 (1), p.183-188 |
| issn | 0735-1097 1558-3597 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Biological and medical sciences Cardiology. Vascular system Chronic Disease Female Heart Heart Failure - diagnosis Heart Failure - physiopathology Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Hypertension, Pulmonary - diagnosis Hypertension, Pulmonary - physiopathology Male Medical sciences Middle Aged Prognosis Pulmonary Wedge Pressure - physiology Stroke Volume - physiology Systole - physiology Ventricular Function, Right - physiology |
| title | Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure |
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