Poor Right Ventricular Systolic Function (Lower TAPSE) and Higher Pulmonary Artery Systolic Pressure (PASP) Predicts Early Readmissions and All Cause Mortality in Elderly Patients with Heart Failure

2014 ◽  
Vol 20 (8) ◽  
pp. S108 ◽  
Author(s):  
Gunjan Choudhary ◽  
Umashankar Lakshmanadoss ◽  
Hari Prasad ◽  
Ashok Shah ◽  
Zaruhi Babayan ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Artery ◽  
Elderly Patients ◽  
Systolic Function ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Ventricular Systolic Function ◽  
Patients With Heart Failure ◽  
Right Ventricular Systolic Function ◽  
All Cause Mortality

Abstract 307: Poor Right Ventricular Systolic Function (lower TAPSE) and Higher Pulmonary Artery Systolic Pressure (PASP) Predicts Early Readmissions and all Cause Mortality in Elderly Patients with Heart Failure

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Gunjan Choudhary ◽  
Umashankar Lakshmanadoss ◽  
Hari Prasad ◽  
Zaruhi Babayan ◽  
Dwight Stapleton
Keyword(s):  
Heart Failure ◽  
Pulmonary Artery ◽  
Elderly Patients ◽  
Right Ventricular ◽  
Systolic Dysfunction ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
All Cause Mortality ◽  
Early Readmission ◽  
Rv Function

Background: Heart failure(HF) related early readmission (<30days) and mortality is higher in elderly patients. Right ventricular (RV) dysfunction is associated with worse prognosis in patients with HF with reduced ejection fraction (HFrEF). We evaluated effect of RV function (as measured by TAPSE - Tricuspid annular plane systolic excursion) and Pulmonary artery systolic pressure (PASP) on early HF readmission and mortality in elderly HF patients. Methods: This is single center observational study of elderly (≥65 years )patients with HFrEF. Patients with principal discharge diagnosis of HFrEF are included (n = 278, age 77 ± 9 years, 38% female, LVEF 29% ± 9%). Demographic and echocardiographic data are collected. TAPSE (as a marker of RV systolic dysfunction) and PASP are measured as per ASE guidelines. Prediction models are performed. Results: Among 278 patients, 62 patients ( 22.3%) had HF related early readmission and 123 patients (44%) died at the end of 5 year. On univariate analysis, older age, Hypertension, Diabetes, higher PASP , RV systolic dysfunction (TAPSE <16mm) and BMI< 25 are predictors of early readmission and mortality (P value <0.05). On multivariate logistic regression analysis, early HF readmission was predicted by TAPSE <16 mm (OR=23.6; p < 0.001; CI 10.23-54.60) and PASP >50 mmHg ( OR = 34; p < 0.001; 95 CI 14.08-82.81); five year all cause mortality was predicted by TAPSE < 16mm (OR = 1.85; p 0.023; 95 CI 1.08-3.16) and PASP >50 mmHg (OR = 2.11; p 0.009; 95 CI 1.19-3.72). Conclusion: TAPSE <16 mm and PASP >50 mmHg are strong predictors of early readmission and five year all cause mortality in elderly HF patients. The assessment of RV function through TAPSE and PASP, helps to risk-stratify elderly patients with HFrEF.

scholarly journals Longitudinal Associations of Fitness and Obesity in Young Adulthood With Right Ventricular Function and Pulmonary Artery Systolic Pressure in Middle Age: The CARDIA Study

2021 ◽  
Author(s):  
Kershaw V. Patel ◽  
Mark Metzinger ◽  
Bryan Park ◽  
Norrina Allen ◽  
Colby Ayers ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Artery ◽  
Young Adulthood ◽  
Middle Age ◽  
Systolic Function ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Tricuspid Annulus ◽  
Baseline Bmi

Background Low cardiorespiratory fitness (CRF) and obesity are risk factors for heart failure but their associations with right ventricular (RV) systolic function and pulmonary artery systolic pressure (PASP) are not well understood. Methods and Results Participants in the CARDIA (Coronary Artery Risk Development in Young Adults) study who underwent maximal treadmill testing at baseline and had a follow‐up echocardiographic examination at year 25 were included. A subset of participants had repeat CRF and body mass index (BMI) assessment at year 20. The associations of baseline and changes in CRF and BMI on follow‐up (baseline to year 20) with RV systolic function parameters (tricuspid annular plane systolic excursion, RV Doppler systolic velocity of the lateral tricuspid annulus), and PASP were assessed using multivariable‐adjusted linear regression models. The study included 3433 participants. In adjusted analysis, higher baseline BMI but not CRF was significantly associated with higher PASP. Among RV systolic function parameters, higher baseline CRF and BMI were significantly associated with higher tricuspid annular plane systolic excursion and RV systolic velocity of the lateral tricuspid annulus. In the subgroup of participants with follow‐up assessment of CRF or BMI at year 20, less decline in CRF was associated with higher RV systolic velocity of the lateral tricuspid annulus and lower PASP, while greater increase in BMI was significantly associated with higher PASP in middle age. Conclusions Higher CRF in young adulthood and less decline in CRF over time are each significantly associated with better RV systolic function. Higher baseline BMI and greater age‐related increases in BMI are each significantly associated with higher PASP in middle age. These findings provide insights into possible mechanisms through which low fitness and obesity may contribute toward risk of heart failure.

scholarly journals It is easy to see, but it is better to foresee: a case report on the favourable alliance between CardioMEMS and levosimendan

2020 ◽  
Vol 4 (4) ◽  
pp. 1-5
Author(s):  
Valeria Visco ◽  
Cristina Esposito ◽  
Paolo Vitillo ◽  
Carmine Vecchione ◽  
Michele Ciccarelli
Keyword(s):  
Heart Failure ◽  
Hospital Admissions ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Optimal Management ◽  
Reduced Ejection Fraction ◽  
The Past ◽  
Case Summary ◽  
Pressure Profiles ◽  
Patients With Heart Failure

Abstract Background In the past years, different devices have been investigated to help in identifying early decompensation events in patients with heart failure (HF) and reduced ejection fraction (EF), reducing hospital admissions. In this report, we present the first patient experience with levosimendan infusion led by CardioMEMS. Case summary A 68-year-old man with HF and reduced EF with more than 20 hospitalizations for exacerbation of HF was enrolled in our HF Clinic from October 2017. Echocardiogram showed a dilated left ventricle with severely reduced EF (29%) and increased pulmonary artery systolic pressure (40 mmHg). From October 2017 to May 2019, the patient went through numerous hospitalizations, despite optimal medical therapy; subsequently, was adopted a strategy of levosimendan infusions guided by CardioMEMS. Levosimendan infusions improved haemodynamic and pressure profiles. The patient was monitored daily by CardioMEMS, and from June to December 2019, he had only two hospitalizations scheduled for levosimendan infusion and none for HF exacerbation. Discussion Our case supports the combination of CardioMEMS and levosimendan for the optimal management of patients with advanced HF. These results further strengthen the development of a randomized clinical trial to demonstrate the clinical usefulness of this device in combination with the levosimendan infusion programme in advanced HF patients.

Sign in / Sign up

Export Citation Format

Share Document