Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart Failure
Aim: To test if the newly described haemodynamic variable, aortic pulsatility index (API), predicts long-term prognosis in advanced heart failure (HF). Methods: A single-centre study on 453 HF patients (median age: 51 years; left ventricular ejection fraction [LVEF]: 19% ± 9%) referred for right hea...
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| Format: | Article |
| Language: | English |
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Radcliffe Medical Media
2022-05-01
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| Series: | Cardiac Failure Review |
| Online Access: | https://www.cfrjournal.com/articleindex/cfr.2022.09 |
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| author | Tania Deis Kasper Rossing Finn Gustafsson |
| author_facet | Tania Deis Kasper Rossing Finn Gustafsson |
| author_sort | Tania Deis |
| collection | DOAJ |
| description | Aim: To test if the newly described haemodynamic variable, aortic pulsatility index (API), predicts long-term prognosis in advanced heart failure (HF). Methods: A single-centre study on 453 HF patients (median age: 51 years; left ventricular ejection fraction [LVEF]: 19% ± 9%) referred for right heart catheterisation. API was calculated as pulse pressure/pulmonary capillary wedge pressure. Results: Log(API) correlated significantly with central venous pressure (CVP; p<0.001) and cardiac index (p<0.001) in univariable regression analysis. CVP remained associated with log(API) in a multivariable analysis including cardiac index, heart rate, log(NT-proBNP [N-terminal proB-type natriuretic peptide]), LVEF, New York Heart Association (NYHA) class III or IV and sex (p=0.01). In univariable Cox models, log(API) was a significant predictor of freedom from the combined endpoint of death, left ventricular assist device implantation, total artificial heart implantation or heart transplantation (HR 0.33; (95% CI [0.22–0.49]); p<0.001) and all-cause mortality (HR 0.56 (95% CI [0.35–0.90]); p=0.015). After adjusting for age, sex, NYHA class III or IV and estimated glomerular filtration rate in multivariable Cox models, log(API) remained a significant predictor for the combined endpoint (HR 0.33; 95% CI [0.20–0.56]; p<0.001) and all-cause mortality (HR 0.49; 95% CI [0.26–0.96]; p=0.034). Conclusion: API was strongly associated with right-sided filling pressure and independently predicted freedom from the combined endpoint and all-cause mortality. |
| format | Article |
| id | doaj-art-15a7b5b34143482bbf73a164d4e88c3d |
| institution | Kabale University |
| issn | 2057-7540 2057-7559 |
| language | English |
| publishDate | 2022-05-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | Cardiac Failure Review |
| spelling | doaj-art-15a7b5b34143482bbf73a164d4e88c3d2024-12-14T16:03:39ZengRadcliffe Medical MediaCardiac Failure Review2057-75402057-75592022-05-01810.15420/cfr.2022.09Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart FailureTania Deis0Kasper Rossing1Finn Gustafsson2Department of Cardiology, Rigshospitalet, Copenhagen, DenmarkDepartment of Cardiology, Rigshospitalet, Copenhagen, DenmarkDepartment of Cardiology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, DenmarkAim: To test if the newly described haemodynamic variable, aortic pulsatility index (API), predicts long-term prognosis in advanced heart failure (HF). Methods: A single-centre study on 453 HF patients (median age: 51 years; left ventricular ejection fraction [LVEF]: 19% ± 9%) referred for right heart catheterisation. API was calculated as pulse pressure/pulmonary capillary wedge pressure. Results: Log(API) correlated significantly with central venous pressure (CVP; p<0.001) and cardiac index (p<0.001) in univariable regression analysis. CVP remained associated with log(API) in a multivariable analysis including cardiac index, heart rate, log(NT-proBNP [N-terminal proB-type natriuretic peptide]), LVEF, New York Heart Association (NYHA) class III or IV and sex (p=0.01). In univariable Cox models, log(API) was a significant predictor of freedom from the combined endpoint of death, left ventricular assist device implantation, total artificial heart implantation or heart transplantation (HR 0.33; (95% CI [0.22–0.49]); p<0.001) and all-cause mortality (HR 0.56 (95% CI [0.35–0.90]); p=0.015). After adjusting for age, sex, NYHA class III or IV and estimated glomerular filtration rate in multivariable Cox models, log(API) remained a significant predictor for the combined endpoint (HR 0.33; 95% CI [0.20–0.56]; p<0.001) and all-cause mortality (HR 0.49; 95% CI [0.26–0.96]; p=0.034). Conclusion: API was strongly associated with right-sided filling pressure and independently predicted freedom from the combined endpoint and all-cause mortality.https://www.cfrjournal.com/articleindex/cfr.2022.09 |
| spellingShingle | Tania Deis Kasper Rossing Finn Gustafsson Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart Failure Cardiac Failure Review |
| title | Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart Failure |
| title_full | Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart Failure |
| title_fullStr | Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart Failure |
| title_full_unstemmed | Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart Failure |
| title_short | Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart Failure |
| title_sort | aortic pulsatility index a new haemodynamic measure with prognostic value in advanced heart failure |
| url | https://www.cfrjournal.com/articleindex/cfr.2022.09 |
| work_keys_str_mv | AT taniadeis aorticpulsatilityindexanewhaemodynamicmeasurewithprognosticvalueinadvancedheartfailure AT kasperrossing aorticpulsatilityindexanewhaemodynamicmeasurewithprognosticvalueinadvancedheartfailure AT finngustafsson aorticpulsatilityindexanewhaemodynamicmeasurewithprognosticvalueinadvancedheartfailure |