Association of peripheral venous pressure with adverse post-discharge outcomes in patients with acute heart failure: a prospective cohort study.

Autor:	Nagao K; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, 5-30 Fudegasaki, Tennouji-ku, 543-8555 Osaka, Japan.; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, 606-8507 Kyoto, Japan., Maruichi-Kawakami S; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, 5-30 Fudegasaki, Tennouji-ku, 543-8555 Osaka, Japan., Aida K; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, 5-30 Fudegasaki, Tennouji-ku, 543-8555 Osaka, Japan., Matsuto K; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, 5-30 Fudegasaki, Tennouji-ku, 543-8555 Osaka, Japan., Imamoto K; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, 5-30 Fudegasaki, Tennouji-ku, 543-8555 Osaka, Japan., Tamura A; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, 5-30 Fudegasaki, Tennouji-ku, 543-8555 Osaka, Japan., Takazaki T; Department of Cardiovascular Surgery, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Nakatsu T; Department of Cardiovascular Surgery, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Tanaka M; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, 5-30 Fudegasaki, Tennouji-ku, 543-8555 Osaka, Japan., Nakayama S; Department of Cardiovascular Surgery, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Morimoto T; Department of Clinical Epidemiology, Hyogo College of Medicine, Hyogo, Japan., Kimura T; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, 606-8507 Kyoto, Japan., Inada T; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, 5-30 Fudegasaki, Tennouji-ku, 543-8555 Osaka, Japan.
Jazyk:	angličtina
Zdroj:	European heart journal. Acute cardiovascular care [Eur Heart J Acute Cardiovasc Care] 2022 Jun 14; Vol. 11 (5), pp. 407-417.
DOI:	10.1093/ehjacc/zuac043
Abstrakt:	Aims: Congestion is the major cause of hospitalization for heart failure (HF). Traditional bedside assessment of congestion is limited by insufficient accuracy. Peripheral venous pressure (PVP) has recently been shown to accurately predict central venous congestion. We examined the association between PVP before discharge and post-discharge outcomes in hospitalized patients with acute HF. Methods and Results: Bedside PVP measurement at the forearm vein and traditional clinical examination were performed in 239 patients. The association with the primary composite endpoint of cardiovascular death or HF hospitalization and the incremental prognostic value beyond the established HF risk score was examined. The PVP correlated with peripheral oedema, jugular venous pressure, and inferior vena cava diameter, but not with brain-type natriuretic peptide. The 1-year incidence of the primary outcome measure in the first, second, and third tertiles of PVP was 21.4, 29.9, and 40.7%, respectively (log-rank P = 0.017). The adjusted hazard ratio of PVP per 1 mmHg increase for the 1-year outcome was 1.08 [95% confidence interval (1.03-1.14), P = 0.004]. When added onto the Meta-Analysis Global Group in Chronic HF risk score, PVP significantly increased the area under the receiver-operating characteristic curve for predicting the outcome [from 0.63 (0.56-0.71) to 0.70 (0.62-0.77), P = 0.02), while traditional assessments did not. The addition of PVP also yielded significant net reclassification improvement [0.46 (0.19-0.74), P < 0.001]. Conclusion: The PVP at discharge correlated with prognosis. The results warrant further investigation to evaluate the clinical application of PVP measurement in the care of HF. Trial Registration Number: UMIN000034279. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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