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Echocardiographic estimation of pulmonary arterial systolic pressure in acute heart failure. Prognostic implications.

Abstract：

BACKGROUND:Prognostic implications of echocardiographic assessment of pulmonary hypertension (PH) in non-selected patients hospitalized for acute heart failure (AHF) are not clearly defined. The aim of this study was to evaluate the association between echocardiography-derived PH in AHF and 1-year all-cause mortality. METHODS:We prospectively included 1210 consecutive patients admitted for AHF. Patients with significant heart valve disease were excluded. Pulmonary arterial systolic pressure (PASP) was estimated using transthoracic echocardiography during hospitalization (mean time after admission 96±24h). Patients were categorized as follows: non-measurable, normal PASP (PASP≤35mmHg), mild (PASP 36-45mmHg), moderate (PASP 46-60mmHg) and severe PH (PASP >60mmHg). The independent association between PASP and 1-year mortality was assessed with Cox regression analysis. RESULTS:At 1-year follow-up, 232 (19.2%) deaths were registered. PASP was measured in 502 (41.6%) patients with a median of 46 [38-55] mmHg. The distribution of population was: 708 (58.5%), 76 (6.3%), 147 (12.1%), 190 (15.7%) and 89 (7.4%) for non-measurable, normal PASP, mild, moderate and severe PH, respectively. One-year mortality was lower for patients with normal PASP (1.32 per 10 person-years), intermediate for patients with non-measurable, mild and moderate PH (2.48, 2.46 and 2.62 per 10 persons-year, respectively) and higher for those with severe PH (4.89 per 10 person-years). After multivariate adjustment, only patients with PASP >60mmHg displayed significant adjusted increase in the risk of 1-year all-cause mortality, compared to patients with normal PASP (HR=2.56; CI 95%: 1.05-6.22, p=0.038). CONCLUSIONS:In AHF, severe pulmonary hypertension derived by echocardiography is an independent predictor of 1-year-mortality.

journal_name

Eur J Intern Med

journal_title

European journal of internal medicine

authors

Merlos P,Núñez J,Sanchis J,Miñana G,Palau P,Bodí V,Husser O,Santas E,Bondanza L,Chorro FJ

doi

10.1016/j.ejim.2013.04.009

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

562-7

issue

6

eissn

0953-6205

issn

1879-0828

pii

S0953-6205(13)00112-X

journal_volume

24

pub_type

杂志文章

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