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Página principal > Artículos > Artículos publicados > Right Ventricular Dysfunction Staging System for Mortality Risk Stratification in Heart Failure with Preserved Ejection Fraction |
Fecha: | 2020 |
Resumen: | Right ventricular dysfunction (RVD) parameters are increasingly important features in heart failure with preserved ejection fraction (HFpEF). We sought to evaluate the prognostic impact of a progressive RVD staging system by combining the tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (TAPSE/PASP) ratio with functional tricuspid regurgitation (TR) severity. We prospectively included 1355 consecutive HFpEF patients discharged for acute heart failure (HF). Of them, in 471 (34. 7%) patients, PASP could not be accurately measured, leaving the final sample size to be 884 patients. Patients were categorized as Stage 1: TAPSE/PASP ≥ 0. 36 without significant TR; stage 2: TAPSE/PASP ≥ 0. 36 with significant TR; stage 3: TAPSE/PASP < 0. 36 without significant TR; and stage 4: TAPSE/PASP < 0. 36 with significant TR. By the 1 year follow-up, 207 (23. 4%) patients had died. We found a significant and graded association between RVD stages and mortality rates (15. 8%, 25%, 31. 2%, and 45. 4% from stage 1 to stage 4, respectively; log-rank test, p < 0. 001). After multivariable adjustment, and compared to stage 1, stages 3 and 4 were independently associated with mortality risk (HR: 1. 8219; 95% CI 1. 308-2. 538; p < 0. 001 and HR = 2. 2632; 95% CI 1. 540-3. 325; p < 0. 001, respectively). A RVD staging system, integrating TAPSE/PASP and TR, provides a comprehensive and widely available tool for risk stratification in HFpEF. |
Ayudas: | Instituto de Salud Carlos III PI17/01426 Ministerio de Economía y Competitividad 16/11/00420 Ministerio de Economía y Competitividad 16/11/00403 |
Derechos: | Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. |
Lengua: | Anglès |
Documento: | Article ; recerca ; Versió publicada |
Materia: | Heart failure with preserved ejection fraction ; Right ventricular ; Risk stratification |
Publicado en: | Journal of clinical medicine, Vol. 9 (march 2020) , ISSN 2077-0383 |
14 p, 1.6 MB |