Effect of right ventricular function and pulmonary pressures on heart failure prognosis.
The relationship of right ventricular function and pulmonary systolic pressure in patients with congestive heart failure was evaluated to risk-stratify them. The study included 147 consecutive patients with symptomatic heart failure who underwent clinical and laboratory examination and echocardiography including Doppler tissue echocardiography. They were followed for a mean of 11.2+/-6.4 months. During follow-up, 16 patients died and 45 patients had nonfatal cardiac events. There were 60 readmissions for heart failure. Pulmonary artery systolic pressure and right ventricular systolic function were inversely related (r(2)=0.66, P<.001). On Cox multivariate survival analysis, early worsening of pulmonary arterial pressures was an independent prognostic predictor (hazard ratio, 0.44; confidence interval, 0.28-0.91, P=.024). The patients with pulmonary hypertension and right ventricular systolic dysfunction had the worst prognosis. The assessments of right ventricular function help to risk-stratify patients with heart failure. The early worsening of pulmonary hypertension is a powerful predictor of worse prognosis.
Adhyapak
Srilakshmi M
SM
Department of Cardiology, St. John's Medical College Hospital, Bangalore, India. srili2881967@yahoo.com
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016001:Confidence Intervals; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011669:Pulmonary Wedge Pressure; D012372:ROC Curve; D012119:Respiration; D012307:Risk Factors; D013223:Statistics as Topic; D013318:Stroke Volume; D016019:Survival Analysis; D013599:Systole; D016278:Ventricular Function, Right