2024-03-19T02:58:54Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/869632022-11-17T02:08:08Zhdl_2115_35410hdl_2115_35409Prognostic value of an echocardiographic index reflecting right ventricular operating stiffness in patients with heart failureFujisawa, RyosukeOkada, KazunoriKaga, SanaeMurayama, MichitoNakabachi, MasahiroYokoyama, ShinobuNishino, HisaoTanemura, AsukaMasauzi, NobuoMotoi, KoIshizaka, SuguruChiba, YasuyukiTsujinaga, ShingoIwano, HiroyukiAnzai, ToshihisaEchocardiographyRight ventricular stiffnessHeart failurePrognosis490Purpose We recently reported a noninvasive method for the assessment of right ventricular (RV) operating stiffness that is obtained by dividing the atrial-systolic descent of the pulmonary artery-RV pressure gradient (PRPGD(AC)) derived from the pulmonary regurgitant velocity by the tricuspid annular plane movement during atrial contraction (TAPM(AC)). Here, we investigated whether this parameter of RV operating stiffness, PRPGD(AC)/TAPM(AC), is useful for predicting the prognosis of patients with heart failure (HF). Methods We retrospectively included 127 hospitalized patients with HF who underwent an echocardiographic examination immediately pre-discharge. The PRPGD(AC)/TAPM(AC) was measured in addition to standard echocardiographic parameters. Patients were followed until 2 years post-discharge. The endpoint was the composite of cardiac death, readmission for acute decompensation, and increased diuretic dose due to worsening HF. Results 58 patients (46%) experienced the endpoint during follow-up. Univariable and multivariable Cox regression analyses demonstrated that the PRPGD(AC)/TAPM(AC) was associated with the endpoint. In a Kaplan-Meier analysis, the event rate of the greater PRPGD(AC)/TAPM(AC) group was significantly higher than that of the lesser PRPGD(AC)/TAPM(AC) group. In a sequential Cox analysis for predicting the endpoint's occurrence, the addition of PRPGD(AC)/TAPM(AC) to the model including age, sex, NYHA functional classification, brain natriuretic peptide level, and several echocardiographic parameters including tricuspid annular plane systolic excursion significantly improved the predictive power for prognosis. Conclusion A completely noninvasive index of RV operating stiffness, PRPGD(AC)/TAPM(AC), was useful for predicting prognoses in patients with HF, and it showed an incremental prognostic value over RV systolic function.SpringerJournal Articleapplication/pdfhttp://hdl.handle.net/2115/86963https://eprints.lib.hokudai.ac.jp/dspace/bitstream/2115/86963/1/FujisawaR_HeVe2021.pdf0910-8327Heart and vessels3745835922021-10-16enginfo:pmid/34655317info:doi/10.1007/s00380-021-01960-6This is a post-peer-review, pre-copyedit version of an article published in Heart and Vessels. The final authenticated version is available online at: https://doi.org/10.1007/s00380-021-01960-6author