scholarly journals Phenotyping right heart function for prognosticating heart failure

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Cho ◽  
T Uejima ◽  
H Hayama ◽  
Y Yajima ◽  
Y Yamashita
Keyword(s):  
Heart Failure ◽  
Cluster Analysis ◽  
Right Ventricular ◽  
Heart Function ◽  
Hazard Analysis ◽  
Right Heart Failure ◽  
Left Heart ◽  
Right Heart ◽  
Right Heart Function ◽  
Rv Function

Abstract Funding Acknowledgements Type of funding sources: None. Background Right heart failure has been shown to portend poor prognosis. The pathophysiology of right heart function is complex, as right ventricular (RV) function is easily affected by preload and afterload. Purpose To test the hypothesis that machine learning would detect heterogeneity in right heart function and improve risk stratifications in a heart failure population Methods This study included 403 heart failure patients who had a history of hospitalization for decompensation. Patients were excluded if they had primary heart valve disease or pericardial disease or a previous cardiac surgery. Hierarchical clustering was undertaken on right heart variables (RV strain, right ventricular systolic pressure (RVSP), vena contracta of tricuspid regurgitation (TR) and diameter of inferior vena cava) to identify homogenous groups of patients with similar profiles of the variables. Cox hazard analysis was used to elucidate the benefit of clustering over each variable for prognosticating heart failure. Endpoint was hospitalization for worsening heart failure. Results Cluster analysis identified three groups with distinct right heart function. Cluster 1 (n = 191) represented patients with preserved RV function and low RVSP (figure A).  On the other hand, cluster 2 (n = 144) had reduced RV function and low RVSP, while cluster 3 (n = 68) had preserved RV function and high RVSP, associated with severe TR and high central venous pressure. The latter 2 clusters carried worse outcome than cluster 1 (p < 0.001, figure B). Cox hazard analysis demonstrated that, although the addition of each right heart variable to baseline model constructed from left heart variables did not improve predictive power, clusters predicted events with a hazard ratio of 1.566, independent from and incremental to the left heart variables (Figure C). Conclusion Cluster analysis identified two distinct phenotypes of right heart failure that were associated with adverse outcomes. This data-driven phenotyping can help in categorizing right heart failure and better prognosticating heart failure. Abstract Figure.

scholarly journals A case report: intravalvular regurgitation during percutaneous valve-in-ring implantation due to eccentric bulging of a balloon-expandable valve in a patient with severe right heart failure

2019 ◽  
Author(s):  
Muhammed Gerçek ◽  
René Schramm ◽  
Lech Paluszkiewicz ◽  
Tanja Katharina Rudolph
Keyword(s):  
Heart Failure ◽  
Tricuspid Valve ◽  
Heart Function ◽  
Right Heart Failure ◽  
Alternative Methods ◽  
Tricuspid Valve Repair ◽  
Heart Team ◽  
Valve Repair ◽  
Right Heart ◽  
Right Heart Function

Abstract Background Severely reduced right heart function and high operative risk are major challenges in the treatment of tricuspid regurgitation (TR) as both can lead to low cardiac output heart failure (LCO-Hf). Alternative methods and criteria for patient selection are actively being sought. Case summary We report on a 66-year-old patient with severe right heart failure (rHF) with recurrent TR after prior surgical valve repair with a 32-mm-Edwards-MC3 annuloplasty ring (AR). Surgical revision was discarded due to extreme high surgical risk. A right ventricular assist device was discussed but declined by the patient. Percutaneous edge-to-edge repair was not applicable due to massive tethering of the anterior leaflet and complete lack of coadaptation. According to the Heart team decision, percutaneous tricuspid valve-in-ring implantation was performed using a 29-mm Sapien-3 prosthesis (SP3) under moderate balloon overinflation. Despite satisfying positioning, the prosthesis showed massive intravalvular regurgitation due to immobility of the septally oriented cusp, which was most likely caused by eccentric bulging of the prosthesis in the opening region of the AR. Implantation of a second prosthesis leads to a perfectly functional result. Importantly, no major haemodynamic complications ensued. Discussion Although being a potential risk of tricuspid valve repair LCO-hf could not be observed in the present case. Additionally, deformation of the implanted transcatheter aortic valve replacement prosthesis resulting from the regional lack of abutment in AR should be considered as a potential complication. Hence, further careful evaluation of the feasibility of percutaneous tricuspid valve treatment, also in patients with rHF, is needed.

Pickwick syndrome

1982 ◽  
Vol 63 (3) ◽  
pp. 48-51
Author(s):  
V. I. Zhukov
Keyword(s):  
Heart Failure ◽  
Right Heart Failure ◽  
Cor Pulmonale ◽  
Left Heart ◽  
Obesity Hypoventilation Syndrome ◽  
Right Heart ◽  
Left Heart Failure ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Obesity, as you know, is often combined with atherosclerosis, hypertension and their characteristic left-heart failure. Least of all, in our opinion, obesity is associated with cor pulmonale and right-heart failure. "Pickwick syndrome", it is also known as "Ioe syndrome", "cardiopulmonary syndrome of patients with obesity", "obesity-hypoventilation syndrome".

scholarly journals Usefulness of right ventricular contraction pressure index to predict short-term mortality and right heart failure in patients who underwent continuous-flow left ventricular assist device implantation

2019 ◽  
Vol 43 (1) ◽  
pp. 25-36 ◽  
Author(s):  
Koray Kalenderoğlu ◽  
Tolga Sinan Güvenç ◽  
Müge Taşdemir Mete ◽  
Hüseyin Kuplay ◽  
Semra Ağustos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Right Heart Failure ◽  
Left Ventricular ◽  
Ventricular Contraction ◽  
Short Term ◽  
Right Heart ◽  
Ventricular Assist ◽  
Pressure Index ◽  
Short Term Mortality

Background: Right ventricular stroke work index is a useful but invasively measured parameter that can be used to predict right heart failure following continuous-flow left ventricular assist device implantation. Right ventricular contraction pressure index is a novel parameter that was developed to measure right ventricular stroke work index with echocardiography. We aimed to investigate the clinical usefulness of right ventricular contraction pressure index to predict short-term mortality and right heart failure in patients who underwent continuous-flow left ventricular assist device implantation. Methods: A total of 49 patients who participated in institutional advanced heart failure registry and underwent continuous-flow left ventricular assist device implantation with a bridge-to-candidacy indication were analyzed retrospectively. Right ventricular contraction pressure index was calculated using offline measurements. Demographic, clinical and outcome data were obtained from the registry data. Patients were grouped according to right ventricular contraction pressure index quartiles. Results: Patients within the lowest right ventricular contraction pressure index quartile had a trend toward higher short-term mortality (46.2%, p = 0.056) and combined short-term mortality and definitive right heart failure (53.8%, p = 0.054) at 15th day postoperatively. Similarly, short-term survival or survival free of definite right heart failure were significantly lower in the lowest right ventricular contraction pressure index quartile (log-rank p = 0.045 and log-rank p = 0.03, respectively). In a proportional hazards model that included echocardiographic parameters, right ventricular contraction pressure index was an independent predictor for short-term mortality (odds ratio: 6.777, 95% confidence interval: 1.118–41.098, p = 0.037), but not for combined short-term mortality and definite right heart failure. No such associations were found for long-term mortality. Right ventricular contraction pressure index had a statistically significant correlation with invasively measured pulmonary capillary wedge pressure, pulmonary vascular resistance, mean pulmonary pressure, and right ventricular stroke work index. Conclusion: Right ventricular contraction pressure index was found as a useful parameter for determining short-term postoperative mortality in patients undergoing continuous-flow left ventricular assist device implantation.

scholarly journals Metastatic adenocarcinoma involving the right ventricle and pulmonary artery leading to right heart failure: case report

2017 ◽  
Vol 136 (3) ◽  
pp. 262-265 ◽  
Author(s):  
Turgut Karabag ◽  
Caner Arslan ◽  
Turab Yakisan ◽  
Aziz Vatan ◽  
Duygu Sak
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Right Heart Failure ◽  
Ventricular Outflow Tract ◽  
Right Heart ◽  
The Right

ABSTRACT CONTEXT: Obstruction of the right ventricular outflow tract due to metastatic disease is rare. Clinical recognition of cardiac metastatic tumors is rare and continues to present a diagnostic and therapeutic challenge. CASE REPORT: We present the case of a patient who had severe respiratory insufficiency and whose clinical examinations revealed a giant tumor mass extending from the right ventricle to the pulmonary artery. We discuss the diagnostic and therapeutic options. CONCLUSION: In patients presenting with acute right heart failure, right ventricular masses should be kept in mind. Transthoracic echocardiography appears to be the most easily available, noninvasive, cost-effective and useful technique in making the differential diagnosis.

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