scholarly journals Prognostic Value of a Simple Echocardiographic Parameter, the Right Ventricular Systolic to Diastolic Duration Ratio, in Patients with Advanced Heart Failure with Non-Ischemic Dilated Cardiomyopathy

2018 ◽  
Vol 59 (5) ◽  
pp. 968-975 ◽  
Author(s):  
Boqing Xu ◽  
Takayuki Kawata ◽  
Masao Daimon ◽  
Koichi Kimura ◽  
Tomoko Nakao ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
Prognostic Value ◽  
Advanced Heart Failure ◽  
Echocardiographic Parameter ◽  
Non Ischemic Dilated Cardiomyopathy ◽  
The Right

P1678Feasibility of comprehensive multi-plane echocardiographic evaluation of right ventricular function pre-LVAD implantation - preliminary results from a single centre experience

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D J Bowen ◽  
Y C Yalcin ◽  
M Strachinaru ◽  
J S McGhie ◽  
A E Van Den Bosch ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Advanced Heart Failure ◽  
Free Wall ◽  
Heart Failure Patients ◽  
Echocardiographic Evaluation ◽  
The Right

Abstract Introduction Right sided heart failure (RVF) is recognized as a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Despite the publication of several risk scores and predication models, identifying patients at risk for RVF after LVAD implantation remains a challenge. The right ventricle is complex in structure and not possible to fully assess from one echocardiographic 2D plane. Our centre previously introduced a novel multi-plane approach whereby four different RV free wall segments (lateral, anterior, inferior and inferior coronal – figure 1) can be imaged from the same echocardiographic position using electronic plane rotation. Purpose The aim of the study was to determine the feasibility of using multi-plane echocardiography to quantify right ventricular function in a small cohort of advanced heart failure patients prior to LVAD implantation. Methods Twelve advanced heart failure patients underwent detailed RV assessment by multi-plane echocardiography prior to LVAD implantation (median -15 [6.3–29.8] days before). Feasibility and values of the established RV functional echo parameters tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler imaging derived tricuspid annular peak systolic velocity (TDI S') were assessed by an experienced sonographer on each of the 4 free wall segments. Mean values were calculated from an average of 3 measurements. Conventional 2D echo parameters and clinical outcome data post LVAD implantation were also collected. Results Feasibility of TAPSE and TDI measurements in all four RV free wall segments was 100%, with the exception of the inferior coronal wall (91.7% – TDI S' only). Mean 4 wall averaged TAPSE was 13.9±5.1mm, whilst mean TDI S' was 9.4±2.6cm/s. Mean TAPSE and TDI values were lower in the inferior and inferior coronal walls (13.3±5.8mm; 8.8±3.1cm/s and 10.9±5.7mm; 8.9±3.7cm/s) than those of the lateral and anterior walls (15.6±5.1mm; 9.9±2.3cm/s and 15.9±5.1mm; 10.1±2.6cm/s). The cohort was split by using a four wall averaged TAPSE value of 16mm as a cutoff. Mean 4 wall averaged TAPSE was 20.6±1.9mm in the >16mm group compared to 10.5±1.7mm for the <16mm group, whilst mean TDI S' was 9.4±2.6cm/s vs 7.7±0.7cm/s. Post LVAD implantation, there were 3 (25%) deaths and 6 (50%) incidences of acute kidney injury. Median length of stay in ICU and hospital was 4 (1–13.5) and 42.5 (30.3–65) days respectively. The <16mm group had higher incidences of negative outcomes and longer stay in both ICU and hospital following LVAD implantation (p: 0.07). Conclusion Multi-plane echocardiographic evaluation of the right ventricle appears feasible in advanced heart failure with potential for a more comprehensive quantification of right ventricular function pre-LVAD implantation. Larger, ideally multi-centre studies are required to further assess these preliminary findings.

Assessment of right ventricular function in advanced heart failure with nonischemic dilated cardiomyopathy

2020 ◽  
Vol 21 (2) ◽  
pp. 134-143 ◽  
Author(s):  
Francesco Bianco ◽  
Valentina Bucciarelli ◽  
Enrico Ammirati ◽  
Lucia Occhi ◽  
Francesco Musca ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Advanced Heart Failure ◽  
Nonischemic Dilated Cardiomyopathy

P5447Prognostic significance of carboxy-terminal telopeptide (ICTP) and Caspase-3 in patients with non-ischemic dilated cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Kazukauskiene ◽  
V Baltruniene ◽  
D Bironaite ◽  
S Cibiras ◽  
K Rucinskas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Dilated Cardiomyopathy ◽  
Prognostic Value ◽  
Caspase 3 ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
End Point ◽  
Non Ischemic Dilated Cardiomyopathy ◽  
Carboxy Terminal

Abstract Background Non-ischemic dilated cardiomyopathy (niDCM) is a common debilitating disease leading to heart failure and poor prognosis. Therefore, a reliable diagnosis of niDCM and search of prognostic biomarkers is a task of paramount importance preventing final destruction of myocardium and improving the outcomes of the disease. The aim of the study was to evaluate the prognostic value of carboxy-terminal telopeptide (ICTP), a marker of myocardial collagen I degradation, and Caspase-3, a marker of apoptosis, in serum and endomyocardium biopsies (EMBs) of patients with niDCM. Methods 34 consecutive patients (male 25 (78%); 43.83±12.17 years) with niDCM (average of left ventricle (LV) end-diastolic diameter 6.94±0.78 cm, LV ejection fraction 24.97±6.93%, mean pulmonary capillary wedge pressure 32.9±8.7 mmHg) were enrolled in the study. The levels of ICTP and Caspase-3 in patients' serum and EMBs were measured by ELISA. After a follow-up period of 5 years, 18 patients (53%) have reached the primary composite end-point of heart failure: 6 patients (17.6%) died, 6 patients (17.6%) had heart transplantation and 6 patients (17.6%) underwent left ventricle assist device implantation. Results Univariate Cox proportional hazard model and ROC curve analysis identified levels of ICTP and Caspase-3 in serum as predictors of composite end-point (Table 1). However, the levels of ICTP and Caspase-3 in EMBs had no prognostic value. The cut-off values of serum biomarkers for prediction of the outcome were 13.43 pg/mg protein (sensitivity 67%; specificity 81%) for ICTP and 10.21 pg/mg protein (sensitivity 53%; specificity 87%) for Caspase-3. Univariate Cox regression analysis revealed that patients with higher levels of ICTP and Caspase-3 than cut-off values in serum had higher risk of reaching the composite end-point compared to the patients with lower cut-off values (HR 4.4 (95% CI: 1.6–12.1) and 3.15 (95% CI: 1.2–8.29), respectively). Kaplan-Meier survival analysis demonstrated that patients with serum Caspase-3 and ICTP levels above cut-off values had significantly worse outcome (p=0.01 and p=0.002, respectively). Table 1 Biomarkers (pg/mg protein) Mean ± SD HR (95% CI) p-value AUC (95% CI) ICTP in serum 15.26±10.59 1.052 (1.013–1.093) 0.009 0.71 (0.53–0.89) ICTP in EMB 132±295 0.999 (0.998–1.001) 0.56 0.45 (0.28–0.61) Caspase-3 in serum 7.78±9.86 1.047 (1.002–1.093) 0.04 0.69 (0.51–0.87) Caspase-3 in EMB 283±282 1 (0.998–1.002) 0.92 0.50 (0.28–0.72) Conclusion The findings show that increased serum levels of Caspase-3 and ICTP are significantly associated with poor outcome in patients with niDCM. Acknowledgement/Funding the Research Council of Lithuania (Grants nos. MIP-086/2012 and MIP-011/2014), the European Union, EU-FP7, SARCOSI Project (no. 291834)

Prognostic Value of Blood Panel Parameters in Patients With Dilated Cardiomyopathy and Advanced Heart Failure

2018 ◽  
Vol 50 (2) ◽  
pp. 650-652 ◽  
Author(s):  
J.M. Sobrino-Márquez ◽  
A. Grande-Trillo ◽  
E.M. Cantero-Pérez ◽  
D. Rangel-Sousa ◽  
E. Lage-Galle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Prognostic Value ◽  
Advanced Heart Failure

Validity of the right ventricular Doppler index for assessment of severity of congestive heart failure in patients with dilated cardiomyopathy

1999 ◽  
Vol 14 (5) ◽  
pp. 232-239 ◽  
Author(s):  
Chikako Izumi ◽  
Satoshi Kibira ◽  
Hiroyuki Watanabe ◽  
Masayasu Nakagawa ◽  
Susheng Wen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
The Right

scholarly journals 393 Long-term prognostic value of haemodynamic determinants of right ventricular pulsatile afterload in patients with advanced heart failure

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Francesca Rubino ◽  
Roberto Scarsini ◽  
Anna Piccoli ◽  
Livio San Biagio ◽  
Ilaria Tropea ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Primary Endpoint ◽  
Prognostic Value ◽  
Cox Regression ◽  
Left Ventricular ◽  
Advanced Heart Failure ◽  
Strong Impact ◽  
Increased Risk

Abstract Aims Right ventricular (RV) dysfunction demonstrated a strong impact on survival of patients with advanced heart failure with reduced ejection fraction (HFrEF). Increased RV afterload is associated with poor prognosis in patients with HF. To examine the prognostic relevance of RV pulsatile afterload parameters, in particular pulmonary artery compliance (PAC), elastance (PAE), and pulsatile index (PAPi) in a large cohort of patients with advanced HFrEF evaluated for heart transplantation (HT). Methods and results 149 patients with HFrEF enlisted for HT were evaluated with right heart catheterization (RHT) and echocardiography and were followed until death or any censoring events including HT, left ventricular assist device (LVAD), and hospitalization for acute heart failure (HHF). Cox regression and ROC-curve analysis were used to test the prognostic value of RV pulsatile afterload determinants. During a mean observation time of 500 ± 424 days, the primary endpoint occurred in 29 (19.5%) patients. The mean age was 56.6 ± 10.1 years and 85.2% were male. The most frequent etiology of HF was ischaemic cardiomyopathy (52.3%). Mean LV ejection fraction was 25.7 ± 10.2%. Patients who met the primary endpoint were significantly older and with worse haemodynamic profile than event-free survivors. In particular, the primary endpoint occurred in patients with lower PAC (1.8 ± 0.8 vs. 2.7 ± 2.0, P = 0.01), higher mean pulmonary arterial pressure (mPAP) (33.5 ± 11.3 vs. 29.3 ± 11.0, P = 0.05), PVR (3.0 ± 1.6 vs. 2.6 ± 2.0, P = 0.09), and PEA (1.12 ± 0.5 vs. 0.98 ± 0.6, P = 0.04). A significant increased risk of adverse outcome was observed in patients with PAC &lt;1.9 ml/mmHg (HR: 3, 95% CI: 1.3–6, P = 0.007), PEA &gt; 0.9 mmHg/ml (HR: 2.5, 95% CI: 1.1–5.2, P = 0.02) and mPAP ≥25 mmHg (HR: 3.0, 95% CI: 1.0–7.5, P = 0.03). The predictive value of PAC was superior compared with PVR (AUC comparison, P = 0.019) and PAPi (P = 0.03). Conversely, PAC presented similar prognostic accuracy compared with mPAP (P = 0.51) and PEA (P = 0.19). Moreover, PAC demonstrated incremental prognostic value compared with the cardiac index (P = 0.02), whereas mPAP and PAE did not. Conclusions Impaired haemodynamic RV parameters are associated with worse survival in patients with advanced HFrEF. Pulsatile RV afterload indices should be considered in the evaluation of patients enlisted for HT. PAC demonstrated an independent prognostic value in this highly selected cohort of patients awaiting HT.

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