Cardiac index predicts long-term outcomes in patients with heart failure.
<h4>Background</h4>The role of cardiac index (CI) and right atrial pressure (RAP) for predicting long-term outcomes of heart failure has not been well established. The aim of this study was to investigate long-term cardiac outcomes in patients with heart failure having various combinatio...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2021-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0252833 |
| _version_ | 1818721729015447552 |
|---|---|
| author | Tatsuro Ibe Hiroshi Wada Kenichi Sakakura Yusuke Ugata Hisataka Maki Kei Yamamoto Masaru Seguchi Yousuke Taniguchi Hiroyuki Jinnouchi Hideo Fujita |
| author_facet | Tatsuro Ibe Hiroshi Wada Kenichi Sakakura Yusuke Ugata Hisataka Maki Kei Yamamoto Masaru Seguchi Yousuke Taniguchi Hiroyuki Jinnouchi Hideo Fujita |
| author_sort | Tatsuro Ibe |
| collection | DOAJ |
| description | <h4>Background</h4>The role of cardiac index (CI) and right atrial pressure (RAP) for predicting long-term outcomes of heart failure has not been well established. The aim of this study was to investigate long-term cardiac outcomes in patients with heart failure having various combinations of CI and RAP.<h4>Methods</h4>A total of 787 heart failure patients who underwent right-heart catheterization were retrospectively categorized into the following four groups: Preserved CI (≥2.5 L/min/m2) and Low RAP (<8 mmHg) (PRE-CI/L-RAP; n = 285); Preserved CI (≥2.5 L/min/m2) and High RAP (≥8 mmHg) (PRE-CI/H-RAP; n = 242); Reduced CI (<2.5 L/min/m2) and Low RAP (<8 mmHg) (RED-CI/L-RAP; n = 123); and Reduced CI (<2.5 L/min/m2) and High RAP (≥8 mmHg) (RED-CI/H-RAP; n = 137). Survival analysis was applied to investigate which groups were associated with major adverse cardiovascular events (MACE).<h4>Results</h4>The RED-CI/L-RAP and RED-CI/H-RAP groups were significantly associated with MACE as compared with the PRE-CI/L-RAP and PRE-CI/H-RAP groups after adjustment for confounding factors (RED-CI/L-RAP vs. PRE-CI/L-RAP: HR 2.11 [95% CI 1.33-3.37], p = 0.002; RED-CI/H-RAP vs. PRE-CI/L-RAP: HR 2.18 [95% CI 1.37-3.49], p = 0.001; RED-CI/L-RAP vs. PRE-CI/H-RAP: HR 1.86 [95% CI 1.16-3.00], p = 0.01; RED-CI/H-RAP vs. PRE-CI/H-RAP: HR 1.92 [95% CI 1.26-2.92], p = 0.002), whereas the difference between the RED-CI/H-RAP and RED-CI/L-RAP groups was not significant (HR 1.03 [95% CI 0.64-1.66], p = 0.89).<h4>Conclusions</h4>The hemodynamic severity categorized by CI and RAP levels provided clear risk stratification in patients with symptomatic heart failure. Low CI was an independent predictor of long-term cardiac outcomes. |
| first_indexed | 2024-12-17T20:43:21Z |
| format | Article |
| id | doaj.art-3690ae4948794c6c8de152346d6dd5d0 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-17T20:43:21Z |
| publishDate | 2021-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-3690ae4948794c6c8de152346d6dd5d02022-12-21T21:33:14ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01166e025283310.1371/journal.pone.0252833Cardiac index predicts long-term outcomes in patients with heart failure.Tatsuro IbeHiroshi WadaKenichi SakakuraYusuke UgataHisataka MakiKei YamamotoMasaru SeguchiYousuke TaniguchiHiroyuki JinnouchiHideo Fujita<h4>Background</h4>The role of cardiac index (CI) and right atrial pressure (RAP) for predicting long-term outcomes of heart failure has not been well established. The aim of this study was to investigate long-term cardiac outcomes in patients with heart failure having various combinations of CI and RAP.<h4>Methods</h4>A total of 787 heart failure patients who underwent right-heart catheterization were retrospectively categorized into the following four groups: Preserved CI (≥2.5 L/min/m2) and Low RAP (<8 mmHg) (PRE-CI/L-RAP; n = 285); Preserved CI (≥2.5 L/min/m2) and High RAP (≥8 mmHg) (PRE-CI/H-RAP; n = 242); Reduced CI (<2.5 L/min/m2) and Low RAP (<8 mmHg) (RED-CI/L-RAP; n = 123); and Reduced CI (<2.5 L/min/m2) and High RAP (≥8 mmHg) (RED-CI/H-RAP; n = 137). Survival analysis was applied to investigate which groups were associated with major adverse cardiovascular events (MACE).<h4>Results</h4>The RED-CI/L-RAP and RED-CI/H-RAP groups were significantly associated with MACE as compared with the PRE-CI/L-RAP and PRE-CI/H-RAP groups after adjustment for confounding factors (RED-CI/L-RAP vs. PRE-CI/L-RAP: HR 2.11 [95% CI 1.33-3.37], p = 0.002; RED-CI/H-RAP vs. PRE-CI/L-RAP: HR 2.18 [95% CI 1.37-3.49], p = 0.001; RED-CI/L-RAP vs. PRE-CI/H-RAP: HR 1.86 [95% CI 1.16-3.00], p = 0.01; RED-CI/H-RAP vs. PRE-CI/H-RAP: HR 1.92 [95% CI 1.26-2.92], p = 0.002), whereas the difference between the RED-CI/H-RAP and RED-CI/L-RAP groups was not significant (HR 1.03 [95% CI 0.64-1.66], p = 0.89).<h4>Conclusions</h4>The hemodynamic severity categorized by CI and RAP levels provided clear risk stratification in patients with symptomatic heart failure. Low CI was an independent predictor of long-term cardiac outcomes.https://doi.org/10.1371/journal.pone.0252833 |
| spellingShingle | Tatsuro Ibe Hiroshi Wada Kenichi Sakakura Yusuke Ugata Hisataka Maki Kei Yamamoto Masaru Seguchi Yousuke Taniguchi Hiroyuki Jinnouchi Hideo Fujita Cardiac index predicts long-term outcomes in patients with heart failure. PLoS ONE |
| title | Cardiac index predicts long-term outcomes in patients with heart failure. |
| title_full | Cardiac index predicts long-term outcomes in patients with heart failure. |
| title_fullStr | Cardiac index predicts long-term outcomes in patients with heart failure. |
| title_full_unstemmed | Cardiac index predicts long-term outcomes in patients with heart failure. |
| title_short | Cardiac index predicts long-term outcomes in patients with heart failure. |
| title_sort | cardiac index predicts long term outcomes in patients with heart failure |
| url | https://doi.org/10.1371/journal.pone.0252833 |
| work_keys_str_mv | AT tatsuroibe cardiacindexpredictslongtermoutcomesinpatientswithheartfailure AT hiroshiwada cardiacindexpredictslongtermoutcomesinpatientswithheartfailure AT kenichisakakura cardiacindexpredictslongtermoutcomesinpatientswithheartfailure AT yusukeugata cardiacindexpredictslongtermoutcomesinpatientswithheartfailure AT hisatakamaki cardiacindexpredictslongtermoutcomesinpatientswithheartfailure AT keiyamamoto cardiacindexpredictslongtermoutcomesinpatientswithheartfailure AT masaruseguchi cardiacindexpredictslongtermoutcomesinpatientswithheartfailure AT yousuketaniguchi cardiacindexpredictslongtermoutcomesinpatientswithheartfailure AT hiroyukijinnouchi cardiacindexpredictslongtermoutcomesinpatientswithheartfailure AT hideofujita cardiacindexpredictslongtermoutcomesinpatientswithheartfailure |