Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study
Abstract Aims Changes in echocardiographic parameters and biomarkers of cardiac and venous pressures or estimated plasma volume during hospitalization associated with decongestive treatments in acute heart failure (AHF) patients with either preserved left ventricular ejection fraction (LVEF) (HFPEF)...
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.12645 |
| _version_ | 1819095567820652544 |
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| author | Eiichi Akiyama Raphaël Cinotti Kamilė Čerlinskaitė Lucas N.L. Van Aelst Mattia Arrigo Rui Placido Tahar Chouihed Nicolas Girerd Faiez Zannad Patrick Rossignol Marc Badoz Jean‐Marie Launay Etienne Gayat Alain Cohen‐Solal Carolyn S.P. Lam Jeffrey Testani Wilfried Mullens Gad Cotter Marie‐France Seronde Alexandre Mebazaa |
| author_facet | Eiichi Akiyama Raphaël Cinotti Kamilė Čerlinskaitė Lucas N.L. Van Aelst Mattia Arrigo Rui Placido Tahar Chouihed Nicolas Girerd Faiez Zannad Patrick Rossignol Marc Badoz Jean‐Marie Launay Etienne Gayat Alain Cohen‐Solal Carolyn S.P. Lam Jeffrey Testani Wilfried Mullens Gad Cotter Marie‐France Seronde Alexandre Mebazaa |
| author_sort | Eiichi Akiyama |
| collection | DOAJ |
| description | Abstract Aims Changes in echocardiographic parameters and biomarkers of cardiac and venous pressures or estimated plasma volume during hospitalization associated with decongestive treatments in acute heart failure (AHF) patients with either preserved left ventricular ejection fraction (LVEF) (HFPEF) or reduced LVEF (HFREF) are poorly assessed. Methods and results From the metabolic road to diastolic heart failure: diastolic heart failure (MEDIA‐DHF) study, 111 patients were included in this substudy: 77 AHF (43 HFPEF and 34 HFREF) and 34 non‐cardiac dyspnea patients. Echocardiographic measurements and blood samples were obtained within 4 h of presentation at the emergency department and before hospital discharge. In AHF patients, echocardiographic indices of cardiac and venous pressures, including inferior vena cava diameter [from 22 (16–24) mm to 13 (11–18) mm, P = 0.009], its respiratory variability [from 32 (8–44) % to 43 (29–70) %, P = 0.04], medial E/e' [from 21.1 (15.8–29.6) to 16.6 (11.7–24.3), P = 0.004], and E wave deceleration time [from 129 (105–156) ms to 166 (128–203) ms, P = 0.003], improved during hospitalization, similarly in HFPEF and HFREF patients. By contrast, no changes were seen in non‐cardiac dyspnea patients. In AHF patients, all plasma biomarkers of cardiac and venous pressures, namely B‐type natriuretic peptide [from 935 (514–2037) pg/mL to 308 (183–609) pg/mL, P < 0.001], mid‐regional pro‐atrial natriuretic peptide [from 449 (274–653) pmol/L to 366 (242–549) pmol/L, P < 0.001], and soluble CD‐146 levels [from 528 (406–654) ng/mL to 450 (374–529) ng/mL, P = 0.003], significantly decreased during hospitalization, similarly in HFPEF and HFREF patients. Echocardiographic parameters of cardiac chamber dimensions [left ventricular end‐diastolic volume: from 120 (76–140) mL to 118 (95–176) mL, P = 0.23] and cardiac index [from 2.1 (1.6–2.6) mL/min/m2 to 1.9 (1.4–2.4) mL/min/m2, P = 0.55] were unchanged in AHF patients, except tricuspid annular plane systolic excursion (TAPSE) that improved during hospitalization [from 16 (15–19) mm to 19 (17–21) mm, P = 0.04]. Estimated plasma volume increased in both AHF [from 4.8 (4.2–5.6) to 5.1 (4.4–5.8), P = 0.03] and non‐cardiac dyspnea patients (P = 0.01). Serum creatinine [from 1.18 (0.90–1.53) to 1.19 (0.86–1.70) mg/dL, P = 0.89] and creatinine‐based estimated glomerular filtration rate [from 59 (40–75) mL/min/1.73m2 to 56 (38–73) mL/min/1.73m2, P = 0.09] were similar, while plasma cystatin C [from 1.50 (1.20–2.27) mg/L to 1.78 (1.33–2.59) mg/L, P < 0.001] and neutrophil gelatinase associated lipocalin (NGAL) [from 127 (95–260) ng/mL to 167 (104–263) ng/mL, P = 0.004] increased during hospitalization in AHF. Conclusions Echocardiographic parameters and plasma biomarkers of cardiac and venous pressures improved during AHF hospitalization in both acute HFPEF and HFREF patients, while cardiac chamber dimensions, cardiac output, and estimated plasma volume showed minimal changes. |
| first_indexed | 2024-12-21T23:45:22Z |
| format | Article |
| id | doaj.art-f810cb2a4ea6434c81afc48c4956235b |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-21T23:45:22Z |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-f810cb2a4ea6434c81afc48c4956235b2022-12-21T18:46:08ZengWileyESC Heart Failure2055-58222020-06-0173996100610.1002/ehf2.12645Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers studyEiichi Akiyama0Raphaël Cinotti1Kamilė Čerlinskaitė2Lucas N.L. Van Aelst3Mattia Arrigo4Rui Placido5Tahar Chouihed6Nicolas Girerd7Faiez Zannad8Patrick Rossignol9Marc Badoz10Jean‐Marie Launay11Etienne Gayat12Alain Cohen‐Solal13Carolyn S.P. Lam14Jeffrey Testani15Wilfried Mullens16Gad Cotter17Marie‐France Seronde18Alexandre Mebazaa19Inserm UMR‐S 942 Paris FranceInserm UMR‐S 942 Paris FranceInserm UMR‐S 942 Paris FranceInserm UMR‐S 942 Paris FranceInserm UMR‐S 942 Paris FranceCardiology Department Santa Maria University Hospital (CHLN), Lisbon Academic Medical Centre, and Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina Lisbon PortugalInserm UMR‐S 942 Paris FranceINSERM Centre d'Investigations Cliniques Plurithématique 1433 Université de Lorraine, CHRU de Nancy, INSERM U1116 Nancy FranceINSERM Centre d'Investigations Cliniques Plurithématique 1433 Université de Lorraine, CHRU de Nancy, INSERM U1116 Nancy FranceINSERM Centre d'Investigations Cliniques Plurithématique 1433 Université de Lorraine, CHRU de Nancy, INSERM U1116 Nancy FranceDepartment of Cardiology University Hospital Jean Minjoz Besancon FranceInserm UMR‐S 942 Paris FranceInserm UMR‐S 942 Paris FranceInserm UMR‐S 942 Paris FranceNational Heart Centre Singapore and Duke‐National University of Singapore Singapore SingaporeSection of Cardiovascular Medicine Yale University School of Medicine New Haven CT 06510 USADepartment of Cardiology Ziekenhuis Oost‐Limburg Genk BelgiumMomentum Research Inc. Durham NC 27707 USAInserm UMR‐S 942 Paris FranceInserm UMR‐S 942 Paris FranceAbstract Aims Changes in echocardiographic parameters and biomarkers of cardiac and venous pressures or estimated plasma volume during hospitalization associated with decongestive treatments in acute heart failure (AHF) patients with either preserved left ventricular ejection fraction (LVEF) (HFPEF) or reduced LVEF (HFREF) are poorly assessed. Methods and results From the metabolic road to diastolic heart failure: diastolic heart failure (MEDIA‐DHF) study, 111 patients were included in this substudy: 77 AHF (43 HFPEF and 34 HFREF) and 34 non‐cardiac dyspnea patients. Echocardiographic measurements and blood samples were obtained within 4 h of presentation at the emergency department and before hospital discharge. In AHF patients, echocardiographic indices of cardiac and venous pressures, including inferior vena cava diameter [from 22 (16–24) mm to 13 (11–18) mm, P = 0.009], its respiratory variability [from 32 (8–44) % to 43 (29–70) %, P = 0.04], medial E/e' [from 21.1 (15.8–29.6) to 16.6 (11.7–24.3), P = 0.004], and E wave deceleration time [from 129 (105–156) ms to 166 (128–203) ms, P = 0.003], improved during hospitalization, similarly in HFPEF and HFREF patients. By contrast, no changes were seen in non‐cardiac dyspnea patients. In AHF patients, all plasma biomarkers of cardiac and venous pressures, namely B‐type natriuretic peptide [from 935 (514–2037) pg/mL to 308 (183–609) pg/mL, P < 0.001], mid‐regional pro‐atrial natriuretic peptide [from 449 (274–653) pmol/L to 366 (242–549) pmol/L, P < 0.001], and soluble CD‐146 levels [from 528 (406–654) ng/mL to 450 (374–529) ng/mL, P = 0.003], significantly decreased during hospitalization, similarly in HFPEF and HFREF patients. Echocardiographic parameters of cardiac chamber dimensions [left ventricular end‐diastolic volume: from 120 (76–140) mL to 118 (95–176) mL, P = 0.23] and cardiac index [from 2.1 (1.6–2.6) mL/min/m2 to 1.9 (1.4–2.4) mL/min/m2, P = 0.55] were unchanged in AHF patients, except tricuspid annular plane systolic excursion (TAPSE) that improved during hospitalization [from 16 (15–19) mm to 19 (17–21) mm, P = 0.04]. Estimated plasma volume increased in both AHF [from 4.8 (4.2–5.6) to 5.1 (4.4–5.8), P = 0.03] and non‐cardiac dyspnea patients (P = 0.01). Serum creatinine [from 1.18 (0.90–1.53) to 1.19 (0.86–1.70) mg/dL, P = 0.89] and creatinine‐based estimated glomerular filtration rate [from 59 (40–75) mL/min/1.73m2 to 56 (38–73) mL/min/1.73m2, P = 0.09] were similar, while plasma cystatin C [from 1.50 (1.20–2.27) mg/L to 1.78 (1.33–2.59) mg/L, P < 0.001] and neutrophil gelatinase associated lipocalin (NGAL) [from 127 (95–260) ng/mL to 167 (104–263) ng/mL, P = 0.004] increased during hospitalization in AHF. Conclusions Echocardiographic parameters and plasma biomarkers of cardiac and venous pressures improved during AHF hospitalization in both acute HFPEF and HFREF patients, while cardiac chamber dimensions, cardiac output, and estimated plasma volume showed minimal changes.https://doi.org/10.1002/ehf2.12645Acute heart failureCongestionBiomarkerEchocardiographyHeart failure with preserved ejection fractionHeart failure with reduced ejection fraction |
| spellingShingle | Eiichi Akiyama Raphaël Cinotti Kamilė Čerlinskaitė Lucas N.L. Van Aelst Mattia Arrigo Rui Placido Tahar Chouihed Nicolas Girerd Faiez Zannad Patrick Rossignol Marc Badoz Jean‐Marie Launay Etienne Gayat Alain Cohen‐Solal Carolyn S.P. Lam Jeffrey Testani Wilfried Mullens Gad Cotter Marie‐France Seronde Alexandre Mebazaa Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study ESC Heart Failure Acute heart failure Congestion Biomarker Echocardiography Heart failure with preserved ejection fraction Heart failure with reduced ejection fraction |
| title | Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study |
| title_full | Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study |
| title_fullStr | Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study |
| title_full_unstemmed | Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study |
| title_short | Improved cardiac and venous pressures during hospital stay in patients with acute heart failure: an echocardiography and biomarkers study |
| title_sort | improved cardiac and venous pressures during hospital stay in patients with acute heart failure an echocardiography and biomarkers study |
| topic | Acute heart failure Congestion Biomarker Echocardiography Heart failure with preserved ejection fraction Heart failure with reduced ejection fraction |
| url | https://doi.org/10.1002/ehf2.12645 |
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