Monocyte to Lymphocyte Ratio is Associated with Adverse Long Term Outcomes in Patients with Heart Failure

Background The role of cardiac index (CI) and right atrial pressure (RAP) for predicting long-term outcomes of heart failure has not been well established. The aim of this study was to investigate long-term cardiac outcomes in patients with heart failure having various combinations of CI and RAP. Methods A total of 787 heart failure patients who underwent right-heart catheterization were retrospectively categorized into the following four groups: Preserved CI (≥2.5 L/min/m2) and Low RAP (<8 mmHg) (PRE-CI/L-RAP; n = 285); Preserved CI (≥2.5 L/min/m2) and High RAP (≥8 mmHg) (PRE-CI/H-RAP; n = 242); Reduced CI (<2.5 L/min/m2) and Low RAP (<8 mmHg) (RED-CI/L-RAP; n = 123); and Reduced CI (<2.5 L/min/m2) and High RAP (≥8 mmHg) (RED-CI/H-RAP; n = 137). Survival analysis was applied to investigate which groups were associated with major adverse cardiovascular events (MACE). Results The RED-CI/L-RAP and RED-CI/H-RAP groups were significantly associated with MACE as compared with the PRE-CI/L-RAP and PRE-CI/H-RAP groups after adjustment for confounding factors (RED-CI/L-RAP vs. PRE-CI/L-RAP: HR 2.11 [95% CI 1.33–3.37], p = 0.002; RED-CI/H-RAP vs. PRE-CI/L-RAP: HR 2.18 [95% CI 1.37–3.49], p = 0.001; RED-CI/L-RAP vs. PRE-CI/H-RAP: HR 1.86 [95% CI 1.16–3.00], p = 0.01; RED-CI/H-RAP vs. PRE-CI/H-RAP: HR 1.92 [95% CI 1.26–2.92], p = 0.002), whereas the difference between the RED-CI/H-RAP and RED-CI/L-RAP groups was not significant (HR 1.03 [95% CI 0.64–1.66], p = 0.89). Conclusions The hemodynamic severity categorized by CI and RAP levels provided clear risk stratification in patients with symptomatic heart failure. Low CI was an independent predictor of long-term cardiac outcomes.

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A051 Long-term Outcomes for Patients with Heart Failure in New Zealand according to Ejection Fraction Phenotype

Heart Lung and Circulation ◽

10.1016/j.hlc.2020.05.056 ◽

2020 ◽

Vol 29 ◽

pp. S21-S22

Author(s):

T. Evans ◽

K. Poppe ◽

C. Choi ◽

G. Devlin ◽

M. Lund ◽

...

Keyword(s):

Heart Failure ◽

New Zealand ◽

Ejection Fraction ◽

Long Term Outcomes ◽

Patients With Heart Failure

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Myocardial constructive work is a predictor of long-term outcomes in patients with heart failure undergoing cardiac resynchronization therapy

Archives of Cardiovascular Diseases Supplements ◽

10.1016/j.acvdsp.2018.10.060 ◽

2019 ◽

Vol 11 (1) ◽

pp. 29-30

Author(s):

E. Galli ◽

Arnaud Hubert ◽

Alfredo Hernandez ◽

V. Le Rolle ◽

Philippe Mabo ◽

...

Keyword(s):

Heart Failure ◽

Cardiac Resynchronization Therapy ◽

Cardiac Resynchronization ◽

Resynchronization Therapy ◽

Long Term Outcomes ◽

Patients With Heart Failure ◽

Constructive Work

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Long-Term Outcomes in Patients with Heart Failure and Mid-Range Ejection Fraction Undergoing Transcatheter Aortic Valve Replacement

Journal of Cardiac Failure ◽

10.1016/j.cardfail.2018.07.117 ◽

2018 ◽

Vol 24 (8) ◽

pp. S40-S41

Author(s):

Jesus E. Pino ◽

Swethika Sundaravel ◽

Fergie Ramos-Tuarez ◽

Nohora Ximena Torres ◽

Mohammed Kabach ◽

...

Keyword(s):

Heart Failure ◽

Aortic Valve ◽

Ejection Fraction ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Replacement ◽

Long Term Outcomes ◽

Transcatheter Aortic Valve ◽

Patients With Heart Failure

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The treatment of mitral insufficiency in refractory heart failure

European Heart Journal Supplements ◽

10.1093/eurheartj/suaa143 ◽

2020 ◽

Vol 22 (Supplement_L) ◽

pp. L93-L96

Author(s):

Federico Cammertoni ◽

Piergiorgio Bruno ◽

Andrea Mazza ◽

Massimo Massetti

Keyword(s):

Heart Failure ◽

Myocardial Revascularization ◽

Left Ventricular ◽

Mitral Insufficiency ◽

Long Term Outcomes ◽

Mitral Repair ◽

Refractory Heart Failure ◽

Patients With Heart Failure ◽

Frequent Finding

Abstract Secondary mitral insufficiency (SMI) is caused by dilatation and left ventricular dysfunction and is a frequent finding in patients with heart failure (HF). It is associated with a mortality of between 40% and 50% at 3 years. The first-line treatment is represented by medical therapy, possibly associated, when indicated, with cardiac re-synchronization. If the patient remains symptomatic, corrective action should be considered. Surgery is indicated in cases of severe SMI with ejection fraction >30% and the need for myocardial revascularization. The management of patients in whom revascularization is not an option remains extremely complex and the evidence in this field is extremely limited. Percutaneous transcatheter therapies, reparative or replacement, are rapidly emerging as valid alternatives in cases of patients at high surgical risk. In particular, edge-to-edge repair (MitraClip) has proven effective in improving symptoms and reducing hospitalizations for HF. However, neither transcatheter nor surgical mitral repair or replacement has been shown to significantly improve prognosis, with mortality remaining high (14–20% at 1 year). Randomized trials aimed at assessing the effect of these treatments and establishing their long-term outcomes are urgently required.

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