Association Between Right Ventricular Contractile Function and Cardiac Events in Isolated Postcapillary and Combined Pre- and Postcapillary Pulmonary Hypertension.


Journal

Journal of cardiac failure
ISSN: 1532-8414
Titre abrégé: J Card Fail
Pays: United States
ID NLM: 9442138

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 03 02 2019
revised: 19 07 2019
accepted: 13 08 2019
pubmed: 6 9 2019
medline: 16 4 2021
entrez: 6 9 2019
Statut: ppublish

Résumé

Recent studies have shown that patients with combined pre- and postcapillary pulmonary hypertension (CpcPH) had worse outcomes than those with isolated postcapillary pulmonary hypertension (IpcPH). However, the prognostic factors including right ventricular (RV) function have not been well documented. The aim of this study was to assess the differentiation of PH phenotypes, using echocardiography, and the association between RV longitudinal strain and cardiac events. We prospectively recruited consecutive patients who had undergone right heart catheterization. The primary endpoint was cardiovascular death or readmission due to heart failure. We included 137 patients with Group 2 PH. A RV longitudinal strain of 17% was sensitive (85%) and specific (70%) to determine the CpcPH. During a median period of 31 months, 43 patients experienced the primary endpoint during follow-up. In a multivariate analysis, RV longitudinal strain was associated with the primary endpoint in both CpcPH and IpcPH (HR: 0.84, P = 0.003; HR: 0.86, P = 0.001). Lower RV longitudinal strain was independently associated with worse outcomes in CpcPH and IpcPH. RV longitudinal strain may play a prognostic role in PH phenotypes.

Sections du résumé

BACKGROUND BACKGROUND
Recent studies have shown that patients with combined pre- and postcapillary pulmonary hypertension (CpcPH) had worse outcomes than those with isolated postcapillary pulmonary hypertension (IpcPH). However, the prognostic factors including right ventricular (RV) function have not been well documented. The aim of this study was to assess the differentiation of PH phenotypes, using echocardiography, and the association between RV longitudinal strain and cardiac events.
METHODS AND RESULTS RESULTS
We prospectively recruited consecutive patients who had undergone right heart catheterization. The primary endpoint was cardiovascular death or readmission due to heart failure. We included 137 patients with Group 2 PH. A RV longitudinal strain of 17% was sensitive (85%) and specific (70%) to determine the CpcPH. During a median period of 31 months, 43 patients experienced the primary endpoint during follow-up. In a multivariate analysis, RV longitudinal strain was associated with the primary endpoint in both CpcPH and IpcPH (HR: 0.84, P = 0.003; HR: 0.86, P = 0.001).
CONCLUSIONS CONCLUSIONS
Lower RV longitudinal strain was independently associated with worse outcomes in CpcPH and IpcPH. RV longitudinal strain may play a prognostic role in PH phenotypes.

Identifiants

pubmed: 31487533
pii: S1071-9164(19)30143-5
doi: 10.1016/j.cardfail.2019.08.021
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

43-51

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

Kenya Kusunose (K)

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan. Electronic address: kusunosek@tokushima-u.ac.jp.

Nao Yamada (N)

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.

Hirotsugu Yamada (H)

Department of Community medicine for cardiology, Tokushima Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.

Susumu Nishio (S)

Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan.

Yoshihito Saijo (Y)

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.

Yukina Hirata (Y)

Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan.

Yuta Torii (Y)

Ultrasound Examination Center, Tokushima University Hospital, Tokushima, Japan.

Takayuki Ise (T)

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.

Koji Yamaguchi (K)

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.

Daiju Fukuda (D)

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.

Shusuke Yagi (S)

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.

Takeshi Soeki (T)

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.

Tetsuzo Wakatsuki (T)

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.

Masataka Sata (M)

Department of Cardiovascular Medicine, Tokushima University Hospital, Tokushima, Japan.

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