scholarly journals SIGNIFICANCE OF PULMONARY ARTERY CATHETERIZATION ON MORTALITY AND HEART FAILURE READMISSIONS AMONG ACUTE HEART FAILURE WITH PRESERVED EJECTION FRACTION

2021 ◽  
Vol 77 (18) ◽  
pp. 707
Author(s):  
Samarthkumar Thakkar ◽  
Kirtenkumar Patel ◽  
Harsh Patel ◽  
Bryan E-Xin Tan ◽  
Shilpkumar Arora ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Pulmonary Artery ◽  
Acute Heart Failure ◽  
Preserved Ejection Fraction ◽  
Pulmonary Artery Catheterization ◽  
Heart Failure Readmissions

P4512Impact of pulmonary artery catheter on all-cause death of patients with acute heart failure with preserved ejection fraction: Short-term results from the PURSUIT-HFpEF registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
N Matsusaki ◽  
Y Sotomi ◽  
T Kobayashi ◽  
T Hayashi ◽  
Y Takeda ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Acute Heart Failure ◽  
Death Rate ◽  
Significant Risk ◽  
Preserved Ejection Fraction ◽  
Heart Failure Patients ◽  
Kaplan Meier

Abstract Background Appropriate pulmonary artery catheter (PAC) use may effectively decrease mortality in acute heart failure patients. The concept that the pulmonary artery catheter (PAC) is a valuable tool for hemodynamic monitoring when used in appropriately selected patients and by physicians trained well to interpret and apply the data correctly provided has not been evaluated adequately yet in acute heart failure patients with preserved ejection fraction (HFpEF). Methods The PERSUIT-HFpEF Registry is a prospective, observational, multicenter cohort study on prognosis of HFpEF in Japan. Patients hospitalized for heart failure (diagnosed by using Framingham criteria) who met both of the following criteria were enrolled: 1) a left ventricular ejection fraction of 50% or more as measured at the local site by echocardiography; 2) an elevated level of N terminal pro brain natriuretic peptide (NT proBNP) (400 pg per milliliter or more) or brain natriuretic peptide (BNP) (100 pg per milliliter or more). In the present study, we evaluated the impact of PAC on all-cause death of the patients with HFpEF. PAC use was left at the discretion of attending physicians. Results The PERSUIT-HFpEF Registry enrolled 486 patients (81±9 years, 259 females, mean follow-up duration 198±195 days). Of these, data of PAC usage was available in 434 patients. Patients were further stratified according to use of a PAC: PAC 153 patients vs. non-PAC 281 patients. Length of hospitalization was numerically shorter in the PAC group than in the non-PAC group [20.3±14.7 vs. 22.5±17.4 days, p=0.182]. Kaplan-Meier estimated 1-year all-cause death rate was significantly lower in the PAC group than in the non-PAC group (9.5% vs. 19.1%, p=0.019). PAC use was associated with significant risk reduction of all-cause death [hazard ratio (HR) 0.425, 95% confidence interval (CI), 0.203–0.890, p=0.023] in the crude analysis. The significant risk reduction still existed after multivariate adjustment including potential confounders [HR 0.427, 95% CI, 0.185–0.984, p=0.046] Kaplan Meier analysis Conclusions In the real-world Asian registry data, PAC use was associated with the improved all-cause death rate, suggesting that the PAC might be a useful guidance tool for treatment of the patients with HFpEF. Acknowledgement/Funding Roche diagnostics FUJIFILM Toyama Chemical

Acute heart failure with preserved ejection fraction and long-term Readmisions

2008 ◽  
Vol 7 ◽  
pp. 62-63
Author(s):  
J NUNEZ ◽  
L MAINAR ◽  
G MINANA ◽  
R ROBLES ◽  
J SANCHIS ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Preserved Ejection Fraction

Do Patients With Acute Heart Failure and Preserved Ejection Fraction Have Heart Failure at Follow-Up: Implications of the Framingham Criteria

2020 ◽  
Vol 26 (8) ◽  
pp. 673-684
Author(s):  
CAMILLA HAGE ◽  
ULRIKA LÖFSTRÖM ◽  
ERWAN DONAL ◽  
EMMANUEL OGER ◽  
AGNIESZKA KAPŁON-CIEŚLICKA ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Preserved Ejection Fraction

scholarly journals Trimethylamine N‐oxide and outcomes in patients hospitalized with acute heart failure and preserved ejection fraction

2021 ◽  
Author(s):  
Yoshiharu Kinugasa ◽  
Kensuke Nakamura ◽  
Hiroko Kamitani ◽  
Masayuki Hirai ◽  
Kiyotaka Yanagihara ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Preserved Ejection Fraction

Prognostic role of sonographic decongestion in patients with acute heart failure with reduced and preserved ejection fraction: a multicentre study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
N.R Pugliese ◽  
M Mazzola ◽  
G Bandini ◽  
G Barbieri ◽  
S Spinelli ◽  
...  
Keyword(s):  
Heart Failure ◽  
Adverse Events ◽  
Ejection Fraction ◽  
Acute Heart Failure ◽  
Vena Cava ◽  
Composite Endpoint ◽  
Clinical Findings ◽  
Preserved Ejection Fraction ◽  
Net Reclassification Improvement ◽  
B Lines

Abstract Aims Our aim was to assess the dynamic changes of pulmonary congestion (PC) through variations of sonographic B-lines, in addition to conventional clinical, biohumoral and echocardiographic findings, to improve prognostic stratification of patients admitted for acute heart failure with reduced and preserved ejection fraction (HFrEF, HFpEF). Methods In this multicenter, prospective, observational study, lung ultrasound was performed in all patients at admission and before discharge by trained investigators, blinded to clinical findings and outcomes. Results We enrolled 208 consecutive patients admitted for acute heart failure (125 HFrEF, 83 HFpEF, mean age 75.9±11.7 years, 36% females, mean ejection fraction 38%). After 180-day follow-up, 38 composite endpoint events occurred (cardiovascular deaths or HF re-hospitalisations). In a multivariate model, B-lines at discharge had independent prognostic value in the overall population together with NT-proBNP, moderate-to-severe mitral regurgitation (MR) and inferior vena cava diameter at admission. When dividing the population in HFrEF and HFpEF, B-lines at discharge was the only independent parameter to predict events in all subgroups. At ROC analysis, a cut-off of B-lines>15 at discharge displayed the highest accuracy in predicting adverse events (AUC=0.80, p<0.0001). The identification of patients unable to halve B-lines during hospitalization (ΔB-lines%), in addition to B-lines >15 at discharge, improved event classification (integrated discrimination improvement=4%, p=0.01; continuous net reclassification improvement=22.8%, p=0.04). Conclusions The presence of residual subclinical sonographic PC at discharge predicts adverse events in the whole spectrum of acute HF patients, independently of conventional biohumoral and echocardiographic parameters. The dynamic evaluation of pulmonary decongestion during hospital stay can further improve patient risk stratification. Funding Acknowledgement Type of funding source: None

scholarly journals Functional Status, Pulmonary Artery Pressure, and Clinical Outcomes in Heart Failure With Preserved Ejection Fraction

2016 ◽  
Vol 68 (2) ◽  
pp. 189-199 ◽  
Author(s):  
Daniel Dalos ◽  
Julia Mascherbauer ◽  
Caroline Zotter-Tufaro ◽  
Franz Duca ◽  
Andreas A. Kammerlander ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Pulmonary Artery ◽  
Functional Status ◽  
Clinical Outcomes ◽  
Pulmonary Artery Pressure ◽  
Preserved Ejection Fraction ◽  
Artery Pressure

Abstract 13487: Impact of the New Definition of Pulmonary Hypertension in Heart Failure With Preserved Ejection Fraction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Fusako Sera ◽  
Tomohito Ohtani ◽  
kei nakamoto ◽  
Shungo Hikoso ◽  
Daisaku Nakatani ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Pulmonary Artery ◽  
Rank Test ◽  
Heart Catheterization ◽  
Preserved Ejection Fraction ◽  
Multicenter Observational Study ◽  
Definition Of ◽  
The Impact

Introduction: The proposed revision of hemodynamic definition of pulmonary hypertension (PH) adopts a lower threshold of mean pulmonary artery pressure (mPAP) > 20 mmHg. In addition, pulmonary vascular resistance (PVR) ≥ 3 Wood units (WU) is included as the definition of pre-capillary component of PH. Heart failure (HF) with preserved ejection fraction (HFpEF) can develop pre-capillary PH as well as post-capillary PH. We aimed to investigate the impact of the proposed definition of PH on clinical diagnosis of PH associated with HFpEF. Methods: From the PURSUIT-HFpEF (Prospective Multicenter Observational Study of Patients with Heart Failure with Preserved Ejection Fraction) registry, 225 patients who were hospitalized with HF and underwent right heart catheterization were categorized according to the current guidelines and the proposed definition of PH: non-PH, isolated post-capillary PH (Ipc-PH), pre-capillary PH, and combined pre- and post-capillary PH (Cpc-PH). In the proposed definition, patients with mPAP > 20 mmHg, PVR < 3 WU, and pulmonary artery wedge pressure ≤ 15 mmHg do not meet criteria for any of the above categories and are categorized as “unclassified PH”. Results: Prevalence of PH was significantly increased in the proposed definition compared to that in the current definition (51% vs 29%, p<0.0001), with a doubled frequency of pre-capillary PH (Fig A). Furthermore, 24 patients (11%) were diagnosed as unclassified PH and accounted for 22% of those with PH by the proposed definition. Among the PH categories in the proposed definition, Cpc-PH category was significantly relevant for worse prognosis at 1 year after discharge in patients with HFpEF (p=0.03 vs non-PH by log-rank test with Bonferroni's correction) (Fig 2). Conclusions: The new definition of PH resulted in a remarkable increase of prevalence of PH in HFpEF with a quite a few patients with unclassified PH and doubled frequency of pre-capillary PH.

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