Elevated pulmonary arterial elastance and right ventricular uncoupling are associated with greater mortality in advanced heart failure
| Autor: | Leah A. Groves, Ana C. Alba, Elizabeth Karvasarski, J.K. Vishram-Nielsen, Stephen P. Wright, Susanna Mak, Felipe Homem Valle |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Cardiac Catheterization medicine.medical_treatment Heart Ventricles Hemodynamics 030204 cardiovascular system & hematology Pulmonary Artery Elastance 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine Humans In patient Retrospective Studies Heart Failure Ontario Transplantation business.industry Stroke Volume Middle Aged medicine.disease Pulmonary hypertension Survival Rate 030228 respiratory system Heart failure Ventricular assist device Cardiology Arterial elastance Ventricular Function Right Surgery Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 39(7) |
| ISSN: | 1557-3117 |
| Popis: | BACKGROUND The objectives of this study were to describe right ventricular-pulmonary arterial elastance coupling hemodynamic phenotypes and their frequency in patients with advanced heart failure and to evaluate the association of elastance-based indices with all-cause mortality, cardiac transplantation, and left ventricular assist device therapy. METHODS This study included 175 patients with heart failure undergoing right heart catheterization to evaluate candidacy for advanced therapies and 21 healthy controls. We modified a single-beat approach to elastance to account for the magnitude of pulmonary arterial pressure and estimated right ventricular end-systolic elastance (Ees), pulmonary arterial elastance (Ea), and the Ees:Ea ratio. We defined elevated pulmonary arterial load as an Ea > 0.5 mm Hg/ml, and ventriculo-arterial uncoupling as an Ees:Ea RESULTS All 21 controls had Ea ≤ 0.5 mm Hg/ml and Ees:Ea ≥ 0.8. Of 175 patients with heart failure, 63% had Ea > 0.5 mm Hg/ml. Ees:Ea was lower in patients than in controls (p CONCLUSIONS Right ventricular-pulmonary vascular coupling is frequently impaired in heart failure and associated with greater mortality. Elevated pulmonary arterial elastance is associated with greater mortality even when coupling is preserved. |
| Databáze: | OpenAIRE |
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