title: Bed-side inferior vena cava diameter and mean arterial pressure predict long-term mortality in hospitalized patients with heart failure: 36 months of follow-up.
abstract: BACKGROUND
  In discharged patients with heart failure (HF), diverse conditions can intervene to worsen outcome. We would investigate whether such factors present on hospital admission can affect long-term mortality in subjects hospitalized for acute HF.
  
  
  METHODS
  One hundred twenty-three consecutive patients hospitalized for acute HF (mean age 74.8 years; 57% female) were recruited and followed for 36 months after hospitalization.
  
  
  RESULTS
  At multivariate Cox model, only inferior vena cava (IVC) diameter and mean arterial pressure (MAP) registered bed-side on admission, resulted, after correction for all confounders factors, the sole factors significantly associated with a higher risk of all-cause mortality in long-term (HR 1.06, p=0.0057; HR 0.97, p=0.0218; respectively). Study population was subdivided according to median values of IVC diameter (23 mm) and MAP (93.3 mm Hg). The Kaplan–Meier curve showed that HF patients with both IVC ≥ 23 mm and MAP b93.3 mm Hg on admission had reduced probability of survival free from all-cause death (log rank p = 0.0070 and log rank p = 0.0028, respectively).
  
  
  CONCLUSIONS
  In patients hospitalized for acute HF, IVC diameter, measured by hand-carried ultrasound (HCU), and MAP detected on admission are strong predictors of long-term all-cause mortality. The data suggest the need for a careful clinical-therapeutic surveillance on these patients during the post-discharge period. IVC diameter and MAP can be utilized as parameters to stratify prognosis on admission and to be supervised during follow-up.
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Azienda Ospedaliera Universitaria Policlinico (A.O.U.P.) "Paolo Giaccone", Università degli Studi di Palermo, Palermo, Italia.
authors.forename: Daniele
authors.initials: D
authors.lastname: Torres
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Azienda Ospedaliera Universitaria Policlinico (A.O.U.P.) "Paolo Giaccone", Università degli Studi di Palermo, Palermo, Italia. Electronic address: francesco_cuttitta@libero.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cuttitta
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Azienda Ospedaliera Universitaria Policlinico (A.O.U.P.) "Paolo Giaccone", Università degli Studi di Palermo, Palermo, Italia.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Paterna
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Azienda Ospedaliera Universitaria Policlinico (A.O.U.P.) "Paolo Giaccone", Università degli Studi di Palermo, Palermo, Italia.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Garofano
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Azienda Ospedaliera Universitaria Policlinico (A.O.U.P.) "Paolo Giaccone", Università degli Studi di Palermo, Palermo, Italia.
authors.forename: Giosafat
authors.initials: G
authors.lastname: Conti
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Azienda Ospedaliera Universitaria Policlinico (A.O.U.P.) "Paolo Giaccone", Università degli Studi di Palermo, Palermo, Italia.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pinto
authors.affiliation: Dipartimento Biomedico di Medicina Interna e Specialistica, Azienda Ospedaliera Universitaria Policlinico (A.O.U.P.) "Paolo Giaccone", Università degli Studi di Palermo, Palermo, Italia.
authors.forename: Gaspare
authors.initials: G
authors.lastname: Parrinello
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D062186:Arterial Pressure / Q000502:physiology*; D015331:Cohort Studies; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D015999:Multivariate Analysis; D009929:Organ Size; D000067716:Point-of-Care Testing; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Heart failure; Inferior vena cava diameter; Mean arterial pressure; Mortality