Publication:
Prognostic value of pulmonary artery pulsatility index in chronic heart failure patients with reduced ejection fraction

Placeholder

Departments

School / College / Institute

Organizational Unit

Program

KU-Authors

KU Authors

Co-Authors

Yıldız, Ömer

Publication Date

Language

Embargo Status

Journal Title

Journal ISSN

Volume Title

Alternative Title

Abstract

Background The co-existence of right ventricular dysfunction (RVD) in heart failure patient with reduced ejection fraction (HFrEF) is an independent maker of poor prognosis. A novel right ventricular hemodynamic composite measure is the pulmonary artery pulsatility index (PAPi), which is the pulmonary artery pressure gradient ratio. It is a strong predictor of RVD in patients with acute inferior myocardial infarction and patients undergoing left ventricular assist device (LVAD) implantation. However, little is known about its prognostic value in patients with HFrEF. Methods Between September 2010 and July 2013, 172 patients with HFrEF admitted to the tertiary hospital were included in this analysis. We carried out a cardiac catheterisation for each patient, at baseline. Subsequently, we evaluated both PAPi and the other hemodynamic parameters with longitudinal follow-up of adverse outcomes such as cardiac mortality, LVAD, and heart transplantation (HTx). Results During a median follow-up period of 52 months we observed 50 cardiac deaths, 12 LVAD implantations and 10 HTx. A threshold for PAPi value of 2.82 was ascertained (Area: 0.76, p < 0.001, CI: 0.67-0.85, sensitivity 67%, specificity 69%). After dividing the study population into two groups, PAPi <= 2.82 and PAPi >2.82, no significant difference was demonstrated with respect to the aetiology of heart failure (ischaemic HFrEF p = 0.29 and non-ischaemic HFrEF p = 0.29). In Cox regression survival analysis, PAPi was an independent predictor of cardiac death (hazard ratio 0.73 [95% confidence interval 0.53-0.99], p = 0.045). Conclusion In patients with HFrEF, a low PAPi value (<2.82) was associated with increased cardiac mortality risk.

Source

Publisher

Taylor & Francis Ltd

Subject

Cardiac & cardiovascular systems

Citation

Has Part

Source

Acta Cardiologica

Book Series Title

Edition

DOI

10.1080/00015385.2021.1950369

item.page.datauri

Link

Rights

Copyrights Note

Endorsement

Review

Supplemented By

Referenced By

0

Views

0

Downloads

View PlumX Details