| Title: | Prognostic value of an echocardiographic index reflecting right ventricular operating stiffness in patients with heart failure |
| Authors: | Fujisawa, Ryosuke Browse this author |
| Okada, Kazunori Browse this author |
| Kaga, Sanae Browse this author →KAKEN DB |
| Murayama, Michito Browse this author |
| Nakabachi, Masahiro Browse this author |
| Yokoyama, Shinobu Browse this author |
| Nishino, Hisao Browse this author |
| Tanemura, Asuka Browse this author |
| Masauzi, Nobuo Browse this author |
| Motoi, Ko Browse this author |
| Ishizaka, Suguru Browse this author |
| Chiba, Yasuyuki Browse this author |
| Tsujinaga, Shingo Browse this author →KAKEN DB |
| Iwano, Hiroyuki Browse this author →KAKEN DB |
| Anzai, Toshihisa Browse this author →KAKEN DB |
| Keywords: | Echocardiography |
| Right ventricular stiffness |
| Heart failure |
| Prognosis |
| Issue Date: | 16-Oct-2021 |
| Publisher: | Springer |
| Journal Title: | Heart and vessels |
| Volume: | 37 |
| Issue: | 4 |
| Start Page: | 583 |
| End Page: | 592 |
| Publisher DOI: | 10.1007/s00380-021-01960-6 |
| PMID: | 34655317 |
| Abstract: | Purpose 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. |
| Rights: | This 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/s00380-021-01960-6 |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/86963 |
| Appears in Collections: | 保健科学院・保健科学研究院 (Graduate School of Health Sciences / Faculty of Health Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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