Portal de investigación
Right Ventricular Dysfunction Staging System for Mortality Risk Stratification in Heart Failure with Preserved Ejection Fraction
Fecha de publicación:
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Autores de INCLIVA
Participantes ajenos a INCLIVA
- Palau, P
- Lupon, J
Grupos y Plataformas de I+D+i
Abstract
Right ventricular dysfunction (RVD) parameters are increasingly important features in heart failure with preserved ejection fraction (HFpEF). We sought to evaluate the prognostic impact of a progressive RVD staging system by combining the tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (TAPSE/PASP) ratio with functional tricuspid regurgitation (TR) severity. We prospectively included 1355 consecutive HFpEF patients discharged for acute heart failure (HF). Of them, in 471 (34.7%) patients, PASP could not be accurately measured, leaving the final sample size to be 884 patients. Patients were categorized as Stage 1: TAPSE/PASP >= 0.36 without significant TR; stage 2: TAPSE/PASP >= 0.36 with significant TR; stage 3: TAPSE/PASP < 0.36 without significant TR; and stage 4: TAPSE/PASP < 0.36 with significant TR. By the 1 year follow-up, 207 (23.4%) patients had died. We found a significant and graded association between RVD stages and mortality rates (15.8%, 25%, 31.2%, and 45.4% from stage 1 to stage 4, respectively; log-rank test, p < 0.001). After multivariable adjustment, and compared to stage 1, stages 3 and 4 were independently associated with mortality risk (HR: 1.8219; 95% CI 1.308-2.538; p < 0.001 and HR = 2.2632; 95% CI 1.540-3.325; p < 0.001, respectively). A RVD staging system, integrating TAPSE/PASP and TR, provides a comprehensive and widely available tool for risk stratification in HFpEF.
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)
Datos de la publicación
- ISSN/ISSNe:
- 2077-0383, 2077-0383
- Tipo:
- Article
- Páginas:
- -
- DOI:
- 10.3390/jcm9030831
- PubMed:
- 32197527
Journal of Clinical Medicine MDPI
Citas Recibidas en Web of Science: 21
Documentos
Filiaciones
Keywords
- heart failure with preserved ejection fraction; right ventricular; risk stratification
Proyectos y Estudios Clínicos
INCORPORACIÓN DE NUEVAS ÁREAS TEMÁTICAS Y NUEVOS GRUPOS AL CONSORCIO CIBER
Investigador Principal: JUAN SANCHIS FORES
CB16/11/00420 . INSTITUTO SALUD CARLOS III
Retirada del Tratamiento Betabloqueante en Pacientes con Insuficiencia Cardíaca con Función Sistólica Preservada e Incompetencia Cronotrópica. Efecto sobre la Capacidad Funcional.
Investigador Principal: JULIO NUÑEZ VILLOTA
PI17/01426 . INSTITUTO SALUD CARLOS III . 2018
Cita
Santas E,de la Espriella R,Chorro FJ,Palau P,Minana G,Heredia R,Amiguet M,Merenciano H,Sanchis J,Lupon J,Bayes A,Nunez J. Right Ventricular Dysfunction Staging System for Mortality Risk Stratification in Heart Failure with Preserved Ejection Fraction. J. Clin. Med. 2020. 9. (3):831. IF:4,241. (1).
Right Ventricular Dysfunction Staging System for Mortality Risk Stratification in Heart Failure with Preserved Ejection Fraction. Santas E, de la Espriella R, Chorro FJ, Palau P, Minana G, Heredia R, Amiguet M et al. Journal of Clinical Medicine. 2020 marzo 01. 9 (3):DOI:10.3390/jcm9030831. PMID:32197527.
