Echocardiographic derived pulmonary artery wedge pressure is associated with mortality, heart hospitalizations, and functional capacity in chronic systolic heart failure: insights from the HF-ACTION trial.

Autor: Stafford PL; Division of Cardiology, Department of Medicine, University of Virginia Medical Center, PO Box 800158, Charlottesville, VA, 22908-0158, USA., Purvis A; Division of Cardiology, Department of Medicine, University of Virginia Medical Center, PO Box 800158, Charlottesville, VA, 22908-0158, USA., Bilchick K; Division of Cardiology, Department of Medicine, University of Virginia Medical Center, PO Box 800158, Charlottesville, VA, 22908-0158, USA., Nguyen JDK; School of Medicine, University of Virginia, Charlottesville, VA, USA., Patil P; Division of Cardiology, Department of Medicine, University of Virginia Medical Center, PO Box 800158, Charlottesville, VA, 22908-0158, USA., Baldeo C; Division of Cardiology, Department of Medicine, University of Virginia Medical Center, PO Box 800158, Charlottesville, VA, 22908-0158, USA., Mehta N; Division of Cardiology, Department of Medicine, William Beaumont Hospital, Royal Oak, MI, USA., Kwon Y; Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA., Breathett K; Division of Cardiology, Department of Medicine, Indiana University, Indianapolis, IN, USA., Shisler D; Division of Cardiology, Department of Medicine, University of Virginia Medical Center, PO Box 800158, Charlottesville, VA, 22908-0158, USA., Abuannadi M; Division of Cardiology, Department of Medicine, University of Virginia Medical Center, PO Box 800158, Charlottesville, VA, 22908-0158, USA., Bergin J; Division of Cardiology, Department of Medicine, University of Virginia Medical Center, PO Box 800158, Charlottesville, VA, 22908-0158, USA., Philips S; Division of Cardiology, Department of Medicine, University of Virginia Medical Center, PO Box 800158, Charlottesville, VA, 22908-0158, USA., Mazimba S; Division of Cardiology, Department of Medicine, University of Virginia Medical Center, PO Box 800158, Charlottesville, VA, 22908-0158, USA. sm8sd@hscmail.mcc.virginia.edu.
Jazyk: angličtina
Zdroj: Journal of echocardiography [J Echocardiogr] 2024 Jun; Vol. 22 (2), pp. 88-96. Date of Electronic Publication: 2023 Dec 28.
DOI: 10.1007/s12574-023-00630-y
Abstrakt: Background: Heart Failure (HF) is associated with increased morbidity and mortality. Identification of patients at risk for adverse events could lead to improved outcomes. Few studies address the association of echocardiographic-derived PAWP with exercise capacity, readmissions, and mortality in HF.
Methods: HF-ACTION enrolled 2331 outpatients with HF with reduced ejection fraction (HFrEF) who were randomized to aerobic exercise training versus usual care. All patients underwent baseline echocardiography. Echocardiographic-derived PAWP (ePAWP) was assessed using the Nagueh formula. We evaluated the relationship between ePAWP to clinical outcomes.
Results: Among the 2331 patients in the HF-ACTION trial, 2125 patients consented and completed follow-up with available data. 807 of these patients had complete echocardiographic data that allowed the calculation of ePAWP. Of this cohort, mean age (SD) was 58 years (12.7), and 255 (31.6%) were female. The median ePAWP was 14.06 mmHg. ePAWP was significantly associated with cardiovascular death or HF hospitalization (Hazard ratio [HR] 1.02, coefficient 0.016, CI 1.002-1.030, p = 0.022) and all-cause death or HF hospitalization (HR 1.01, coefficient 0.010, CI 1.001-1.020, p = 0.04). Increased ePAWP was also associated with decreased exercise capacity leading to lower peak VO2 (p =  < 0.001), high Ve/VCO2 slope (p =  < 0.001), lower exercise duration (p =  < 0.001), oxygen uptake efficiency (p =  < 0.001), and shorter 6-MWT distance (p =  < 0.001).
Conclusions: Among HFrEF patients, echocardiographic-derived PAWP was associated with increased mortality, reduced functional capacity and heart failure hospitalization. ePAWP may be a viable noninvasive marker to risk stratify HFrEF patients.
(© 2023. Japanese Society of Echocardiography.)
Databáze: MEDLINE
Externí odkaz: