Prognostic implications of post-discharge hemodynamic congestion assessed by peripheral venous pressure among patients discharged from acute heart failure.

Autor: Matsuto K; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Maruichi-Kawakami S; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Aida K; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Imamoto K; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Yukawa H; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Kanazawa T; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Kobayashi Y; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Takahashi N; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Nakagawa E; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Ito H; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Hayashi F; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Makita T; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Inada T; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan., Nagao K; Department of Cardiology, Cardiovascular Center, Osaka Red Cross Hospital, Osaka, Japan. Electronic address: nagao@kuhp.kyoto-u.ac.jp.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2023 Mar 01; Vol. 374, pp. 58-64. Date of Electronic Publication: 2023 Jan 04.
DOI: 10.1016/j.ijcard.2022.12.057
Abstrakt: Background: Congestion is a major cause of hospitalization for heart failure (HF). Peripheral venous pressure (PVP) strongly correlates with right atrial pressure. We recently reported that high PVP at discharge portends a poor prognosis in patients hospitalized for HF. In the same population, we aimed to analyze changes in PVP after discharge and to evaluate prognostic implications of post-discharge PVP.
Methods: PVP was measured at the forearm vein of 163 patients in the 1-month post-discharge follow-up visit. The primary outcome was a composite of cardiovascular death or re-hospitalization for HF after the 1-month follow-up visit up to 1 year after discharge.
Results: Post-discharge PVP correlated with jugular venous pressure, the inferior vena cava diameter, and brain-type natriuretic peptide levels. The cumulative incidence of the primary outcome event was significantly higher in patients with PVP above the median (6 mmHg) than in those with median PVP or lower (39.8% versus 16.9%, Log-rank P = 0.04). Age- and sex-adjusted risk of PVP per 1 mmHg for the primary outcome measure was significant (hazard ratio: 1.12 [95% confidence interval 1.03-1.21]). 35% of patients who had PVP ≤6 mmHg at discharge had PVP >6 mmHg at the 1-month follow-up. PVP significantly decreased from discharge to 1-month follow-up in patients without the primary outcome event (from 6 [4-10] to 6 [4-8] mmHg, P=0.01), but remained high in those with the primary outcome event (from 8 [5-11] to 7 [5-10.5] mmHg, P = 0.9).
Conclusions: PVP measurements during the early post-discharge period may be useful to identify high risk patients.
Trial Registration Number: UMIN000034279.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: