title: Non-invasive measurement of right atrial pressure by near-infrared spectroscopy: preliminary experience. A report from the SICA-HF study.
abstract: To assess the clinical value of measuring right atrial pressure (RAP) using near-infrared spectroscopy (NIRS) in patients with chronic heart failure (CHF).
  
  
  
  RAP was measured non-invasively using NIRS over the external jugular vein (Venus 1000, Mespere LifeSciences, Canada) in ambulatory patients with CHF enrolled in the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF) programme. Comparing 243 patients with CHF (mean age 71 years; mean left ventricular ejection fraction (LVEF) 45%, median NT-proBNP 788 ng/L) to 49 controls (NT-proBNP ≤125 ng/L), RAP was 7 [interquartile range (IQR) 4-11] mmHg vs. 4 (IQR 3-8) mmHg (P < 0.001). Those with RAP ≥10 mmHg (n = 75) were older, had more severe clinical congestion and renal dysfunction, higher plasma NT-proBNP, larger left atrial volume, higher systolic pulmonary pressure and were more often in atrial fibrillation but their LVEF was similar to patients with lower RAP. During a median follow-up of 595 (IQR: 492-714) days, 49 patients (20%) died or were hospitalized for worsening CHF. Compared with patients with RAP ≤5 mmHg, those with RAP ≥10 mmHg had a greater risk of an event (hazard ratio 2.38, 95% confidence interval 1.19-4.75, P = 0.014). RAP measured by NIRS predicted outcome, competing with NT-proBNP in multivariable models.
  
  
  
  Measuring RAP using NIRS identifies ambulatory patients with CHF who have more severe congestion and a worse outcome. The device might be a useful objective method of monitoring RAP, especially for those inexperienced in eliciting physical signs or when measurement of natriuretic peptides is not immediately available.
authors.affiliation: Department of Cardiology, Castle Hill Hospital, Hull York Medical School (at University of Hull), Kingston upon Hull, HU16 5JQ, UK.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Pellicori
authors.affiliation: Department of Cardiology, Castle Hill Hospital, Hull York Medical School (at University of Hull), Kingston upon Hull, HU16 5JQ, UK.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Clark
authors.affiliation: Department of Cardiology, Castle Hill Hospital, Hull York Medical School (at University of Hull), Kingston upon Hull, HU16 5JQ, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Kallvikbacka-Bennett
authors.affiliation: Department of Cardiology, Castle Hill Hospital, Hull York Medical School (at University of Hull), Kingston upon Hull, HU16 5JQ, UK.
authors.forename: Jufen
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Castle Hill Hospital, Hull York Medical School (at University of Hull), Kingston upon Hull, HU16 5JQ, UK.
authors.forename: Alessia
authors.initials: A
authors.lastname: Urbinati
authors.affiliation: Department of Cardiology, Castle Hill Hospital, Hull York Medical School (at University of Hull), Kingston upon Hull, HU16 5JQ, UK.
authors.forename: Luca
authors.initials: L
authors.lastname: Monzo
authors.affiliation: Department of Cardiology, Castle Hill Hospital, Hull York Medical School (at University of Hull), Kingston upon Hull, HU16 5JQ, UK.
authors.forename: Riet
authors.initials: R
authors.lastname: Dierckx
authors.affiliation: University of Göttingen Medical School, Department of Cardiology and Pneumology, Göttingen, Germany.
authors.forename: Stefan D
authors.initials: SD
authors.lastname: Anker
authors.affiliation: Department of Cardiology, Castle Hill Hospital, Hull York Medical School (at University of Hull), Kingston upon Hull, HU16 5JQ, UK.|National Heart & Lung Institute and National Institute of Health Research Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield Hospitals, Imperial College, London, UK.|Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow, Glasgow, UK.
authors.forename: John G F
authors.initials: JGF
authors.lastname: Cleland
mesh_terms: D000368:Aged; D062185:Atrial Pressure / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D007601:Jugular Veins / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D010045:Outpatients; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D013318:Stroke Volume / Q000502:physiology*; D015996:Survival Rate / Q000639:trends; D014463:Ultrasonography; D006113:United Kingdom / Q000453:epidemiology; D016277:Ventricular Function, Left / Q000502:physiology
keywords: Heart failure; Near-infrared spectroscopy; Prognosis; Right atrial pressure