Right Ventricular Dysfunction Staging System for Mortality Risk Stratifiction in Heart Failure with Preserved Ejection Fraction
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Otros documentos de la autoría: Santas, Enrique; De la Espriella, Rafael; Chorro, Francisco J.; Palau, Patricia; Miñana, Gema; Heredia, Raquel; Amiguet Comins, Martina; Merenciano Gonzalez, Hector; Sanchis, Juan; Lupón, Josep; Bayes-Genis, Antoni; Núñez, Julio
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comunitat-uji-handle3:10234/36082
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INVESTIGACIONMetadatos
Título
Right Ventricular Dysfunction Staging System for Mortality Risk Stratifiction in Heart Failure with Preserved Ejection FractionAutoría
Fecha de publicación
2020-03-18Editor
MDPICita bibliográfica
Santas E, De la Espriella R, Chorro FJ, et al. Right Ventricular Dysfunction Staging System for Mortality Risk Stratification in Heart Failure With Preserved Ejection Fraction. J Clin Med. 2020;9(3):831. Published 2020 Mar 18. doi:10.3390/jcm9030831Tipo de documento
info:eu-repo/semantics/articleVersión de la editorial
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141269/Versión
info:eu-repo/semantics/publishedVersionPalabras clave / Materias
Resumen
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 ... [+]
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. [-]
Proyecto de investigación
the Ministry of Economy and Competitiveness, Instituto Carlos III (PI17/01426) ; CIBER Cardiovascular (16/11/00420 and 16/11/00403).Derechos de acceso
info:eu-repo/semantics/openAccess
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