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Prognostic value of an echocardiographic index reflecting right ventricular operating stiffness in patients with heart failure

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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
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:
Type: article (author version)
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)

Submitter: 岡田 一範

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