Hemodynamic Factors Associated With Acute Decompensated Heart Failure: Part 1—Insights into Pathophysiology
Abstract Background The purpose of this study was to determine which pressure-based hemodynamic factor was most closely associated with the transition from chronic compensated to acute decompensated heart failure. Methods and Results Intracardiac pressures were retrospectively examined in 274 heart...
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| Veröffentlicht in: | Journal of cardiac failure 2011-04, Vol.17 (4), p.282-291 |
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| creator | Zile, Michael R., MD Adamson, Philip B., MD Cho, Yong K., PhD Bennett, Tom D., PhD Bourge, Robert C., MD Aaron, Mark F., MD Aranda, Juan M., MD Abraham, William T., MD Stevenson, Lynne Warner, MD Kueffer, Fred J., MS |
| description | Abstract Background The purpose of this study was to determine which pressure-based hemodynamic factor was most closely associated with the transition from chronic compensated to acute decompensated heart failure. Methods and Results Intracardiac pressures were retrospectively examined in 274 heart failure patients using an implantable hemodynamic monitor. The relationship between the development of a heart failure–related event (HFRE) and 3 pressure variables were analyzed: peak estimated pulmonary artery diastolic pressure (ePAD) at the time of an HFRE, change in ePAD from baseline to peak pressure, and the product of ePAD pressure and time (P×T) calculated as the area under the pressure-versus-time curve from baseline to peak pressure. Patients without an HFRE served as control subjects. Peak ePAD and change in ePAD were not closely associated with the development of an HFRE. In patients with an HFRE, P×T was 221 ± 130 mm Hg·days with only 4% of the P×T values 60 mm Hg·days. Conclusions The product of small increases in pressure that occur over an extended period of time (P×T) is the pressure-based hemodynamic factor most closely associated with the transition to acute decompensated heart failure. |
| doi_str_mv | 10.1016/j.cardfail.2011.01.010 |
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Methods and Results Intracardiac pressures were retrospectively examined in 274 heart failure patients using an implantable hemodynamic monitor. The relationship between the development of a heart failure–related event (HFRE) and 3 pressure variables were analyzed: peak estimated pulmonary artery diastolic pressure (ePAD) at the time of an HFRE, change in ePAD from baseline to peak pressure, and the product of ePAD pressure and time (P×T) calculated as the area under the pressure-versus-time curve from baseline to peak pressure. Patients without an HFRE served as control subjects. Peak ePAD and change in ePAD were not closely associated with the development of an HFRE. In patients with an HFRE, P×T was 221 ± 130 mm Hg·days with only 4% of the P×T values <60 mm Hg·days. In contrast, in patients without an HFRE, the P×T was 5 ± 23 with only 4% of the P×T values >60 mm Hg·days. Conclusions The product of small increases in pressure that occur over an extended period of time (P×T) is the pressure-based hemodynamic factor most closely associated with the transition to acute decompensated heart failure.</description><identifier>ISSN: 1071-9164</identifier><identifier>EISSN: 1532-8414</identifier><identifier>DOI: 10.1016/j.cardfail.2011.01.010</identifier><identifier>PMID: 21440865</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>acute decompensation ; Acute Disease ; Aged ; Blood Pressure - physiology ; Cardiovascular ; Disease Progression ; Female ; Heart failure ; Heart Failure - physiopathology ; Hemodynamics ; Humans ; Male ; Middle Aged ; Pulmonary Wedge Pressure - physiology ; Retrospective Studies</subject><ispartof>Journal of cardiac failure, 2011-04, Vol.17 (4), p.282-291</ispartof><rights>Elsevier Inc.</rights><rights>2011 Elsevier Inc.</rights><rights>Copyright © 2011 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c422t-6d7be148a8b6af1f712e13dc3ebaf5cb8eeb618a73d1265286b76716600c3d4a3</citedby><cites>FETCH-LOGICAL-c422t-6d7be148a8b6af1f712e13dc3ebaf5cb8eeb618a73d1265286b76716600c3d4a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.cardfail.2011.01.010$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21440865$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zile, Michael R., MD</creatorcontrib><creatorcontrib>Adamson, Philip B., MD</creatorcontrib><creatorcontrib>Cho, Yong K., PhD</creatorcontrib><creatorcontrib>Bennett, Tom D., PhD</creatorcontrib><creatorcontrib>Bourge, Robert C., MD</creatorcontrib><creatorcontrib>Aaron, Mark F., MD</creatorcontrib><creatorcontrib>Aranda, Juan M., MD</creatorcontrib><creatorcontrib>Abraham, William T., MD</creatorcontrib><creatorcontrib>Stevenson, Lynne Warner, MD</creatorcontrib><creatorcontrib>Kueffer, Fred J., MS</creatorcontrib><title>Hemodynamic Factors Associated With Acute Decompensated Heart Failure: Part 1—Insights into Pathophysiology</title><title>Journal of cardiac failure</title><addtitle>J Card Fail</addtitle><description>Abstract Background The purpose of this study was to determine which pressure-based hemodynamic factor was most closely associated with the transition from chronic compensated to acute decompensated heart failure. Methods and Results Intracardiac pressures were retrospectively examined in 274 heart failure patients using an implantable hemodynamic monitor. The relationship between the development of a heart failure–related event (HFRE) and 3 pressure variables were analyzed: peak estimated pulmonary artery diastolic pressure (ePAD) at the time of an HFRE, change in ePAD from baseline to peak pressure, and the product of ePAD pressure and time (P×T) calculated as the area under the pressure-versus-time curve from baseline to peak pressure. Patients without an HFRE served as control subjects. Peak ePAD and change in ePAD were not closely associated with the development of an HFRE. In patients with an HFRE, P×T was 221 ± 130 mm Hg·days with only 4% of the P×T values <60 mm Hg·days. In contrast, in patients without an HFRE, the P×T was 5 ± 23 with only 4% of the P×T values >60 mm Hg·days. Conclusions The product of small increases in pressure that occur over an extended period of time (P×T) is the pressure-based hemodynamic factor most closely associated with the transition to acute decompensated heart failure.</description><subject>acute decompensation</subject><subject>Acute Disease</subject><subject>Aged</subject><subject>Blood Pressure - physiology</subject><subject>Cardiovascular</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Heart failure</subject><subject>Heart Failure - physiopathology</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pulmonary Wedge Pressure - physiology</subject><subject>Retrospective Studies</subject><issn>1071-9164</issn><issn>1532-8414</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkc1u1DAUhS0EoqXwClV2rDL4Oo7jskCMCu1UqgQSINhZjn3T8ZDEU9tByo6H4Al5kjpMy4IN0pX8d8698ncIOQW6Agri1W5ldLCddv2KUYAVXYo-IsdQV6yUHPjjvKcNlGcg-BF5FuOOUio5bZ6SIwacUynqYzJscPB2HvXgTHGhTfIhFusYvXE6oS2-urQt1mZKWLxD44c9jvHPwwZ1SNnh-ing6-LjcoLfP39djdHdbFMs3Jh8vk5bv9_O0fne38zPyZNO9xFf3K8n5MvF-8_nm_L6w-XV-fq6NJyxVArbtAhcatkK3UHXAEOorKmw1V1tWonYCpC6qSwwUTMp2kY0IASlprJcVyfk5aHvPvjbCWNSg4sG-16P6KeoZH1G66puRFaKg9IEH2PATu2DG3SYFVC1kFY79UBaLaQVXYpm4-n9iKkd0P61PaDNgrcHAeaP_nAYVDQOR4PWBTRJWe_-P-PNPy1M70ZndP8dZ4w7P4UxY1SgIlNUfVryXuIGyFGz-lt1B7bMqac</recordid><startdate>20110401</startdate><enddate>20110401</enddate><creator>Zile, Michael R., MD</creator><creator>Adamson, Philip B., MD</creator><creator>Cho, Yong K., PhD</creator><creator>Bennett, Tom D., PhD</creator><creator>Bourge, Robert C., MD</creator><creator>Aaron, Mark F., MD</creator><creator>Aranda, Juan M., MD</creator><creator>Abraham, William T., MD</creator><creator>Stevenson, Lynne Warner, MD</creator><creator>Kueffer, Fred J., MS</creator><general>Elsevier 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></search><sort><creationdate>20110401</creationdate><title>Hemodynamic Factors Associated With Acute Decompensated Heart Failure: Part 1—Insights into Pathophysiology</title><author>Zile, Michael R., MD ; Adamson, Philip B., MD ; Cho, Yong K., PhD ; Bennett, Tom D., PhD ; Bourge, Robert C., MD ; Aaron, Mark F., MD ; Aranda, Juan M., MD ; Abraham, William T., MD ; Stevenson, Lynne Warner, MD ; Kueffer, Fred J., MS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c422t-6d7be148a8b6af1f712e13dc3ebaf5cb8eeb618a73d1265286b76716600c3d4a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>acute decompensation</topic><topic>Acute Disease</topic><topic>Aged</topic><topic>Blood Pressure - physiology</topic><topic>Cardiovascular</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Heart failure</topic><topic>Heart Failure - physiopathology</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pulmonary Wedge Pressure - physiology</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zile, Michael R., MD</creatorcontrib><creatorcontrib>Adamson, Philip B., MD</creatorcontrib><creatorcontrib>Cho, Yong K., PhD</creatorcontrib><creatorcontrib>Bennett, Tom D., PhD</creatorcontrib><creatorcontrib>Bourge, Robert C., MD</creatorcontrib><creatorcontrib>Aaron, Mark F., MD</creatorcontrib><creatorcontrib>Aranda, Juan M., MD</creatorcontrib><creatorcontrib>Abraham, William T., MD</creatorcontrib><creatorcontrib>Stevenson, Lynne Warner, MD</creatorcontrib><creatorcontrib>Kueffer, Fred J., MS</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>Journal of cardiac failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zile, Michael R., MD</au><au>Adamson, Philip B., MD</au><au>Cho, Yong K., PhD</au><au>Bennett, Tom D., PhD</au><au>Bourge, Robert C., MD</au><au>Aaron, Mark F., MD</au><au>Aranda, Juan M., MD</au><au>Abraham, William T., MD</au><au>Stevenson, Lynne Warner, MD</au><au>Kueffer, Fred J., MS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hemodynamic Factors Associated With Acute Decompensated Heart Failure: Part 1—Insights into Pathophysiology</atitle><jtitle>Journal of cardiac failure</jtitle><addtitle>J Card Fail</addtitle><date>2011-04-01</date><risdate>2011</risdate><volume>17</volume><issue>4</issue><spage>282</spage><epage>291</epage><pages>282-291</pages><issn>1071-9164</issn><eissn>1532-8414</eissn><abstract>Abstract Background The purpose of this study was to determine which pressure-based hemodynamic factor was most closely associated with the transition from chronic compensated to acute decompensated heart failure. Methods and Results Intracardiac pressures were retrospectively examined in 274 heart failure patients using an implantable hemodynamic monitor. The relationship between the development of a heart failure–related event (HFRE) and 3 pressure variables were analyzed: peak estimated pulmonary artery diastolic pressure (ePAD) at the time of an HFRE, change in ePAD from baseline to peak pressure, and the product of ePAD pressure and time (P×T) calculated as the area under the pressure-versus-time curve from baseline to peak pressure. Patients without an HFRE served as control subjects. Peak ePAD and change in ePAD were not closely associated with the development of an HFRE. In patients with an HFRE, P×T was 221 ± 130 mm Hg·days with only 4% of the P×T values <60 mm Hg·days. In contrast, in patients without an HFRE, the P×T was 5 ± 23 with only 4% of the P×T values >60 mm Hg·days. Conclusions The product of small increases in pressure that occur over an extended period of time (P×T) is the pressure-based hemodynamic factor most closely associated with the transition to acute decompensated heart failure.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>21440865</pmid><doi>10.1016/j.cardfail.2011.01.010</doi><tpages>10</tpages></addata></record> |
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| subjects | acute decompensation Acute Disease Aged Blood Pressure - physiology Cardiovascular Disease Progression Female Heart failure Heart Failure - physiopathology Hemodynamics Humans Male Middle Aged Pulmonary Wedge Pressure - physiology Retrospective Studies |
| title | Hemodynamic Factors Associated With Acute Decompensated Heart Failure: Part 1—Insights into Pathophysiology |
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