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• W2070523833 abstract "Background: Several hemodynamic and echo-Doppler measures have been found to be related to the outcome of older patients with chronic systolic HF, but little is known regarding the prognostic role of pulmonary hypertension and right ventricular (RV) dysfunction. The assessment of RV function and pulmonary hemodynamics in HF patients has the potential advantages to be relatively simple, feasible and clinically valuable, as a result of the evaluation of pulmonary artery systolic pressure (PASP) and of the longitudinal annular systolic excursion of the tricuspid annular plane (TAPSE). Recently, TAPSE/PASP was found to be a remarkable prognostic indicator superior than assessing single variables separately. Aim: This echo-Doppler study was designed to evaluate the impact of TAPSE, PASP and their ratio in the prognostic stratification of patients with chronic systolic HF aged >65 years. Methods and results: A complete echocardiographic examination was performed in 413 outpatients with chronic HF and left ventricular ejection fraction <45% who averaged 75 years in age. The estimated PASP was obtained by the sum of the Doppler-derived transtricuspid gradient and the estimated right atrial pressure, as assessed by the inspiratory collapse of the inferior vena cava. RV systolic function was evaluated by M-mode echocardiography using the TAPSE. During a median follow-up period of 28 months, 142 patients died. Two different Cox regression models were evaluated, one including TAPSE and PASP, separately, and the other with TAPSE/PASP. In the first model, NYHA class, TAPSE, and estimated glomerular filtration rate (eGFR) were found to be independently associated with the outcome after adjustment for demographics, clinical, biochemical, echocardiographic data. In the second model, TAPSE/PASP resulted the most important independent predictor of outcome (hazard ratio [HR]:0.18, p=0.0003) followed by age, NYHA class, and eGFR <60 ml/min. The NRI of the model including TASPE/PASP was 18.5% higher than that of the model carrying TAPSE and PASP separately (p<0.0001). IDI increased by 16.3% (p<0.0001), while the value of c-statistics was 0.65 (p<0.0001). Conclusion: The results of the study indicate that the ratio of TAPSE and PASP is of major importance to assess the prognosis of patients with chronic systolic HF aged >65 years." @default.
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• W2070523833 date "2013-08-02" @default.
• W2070523833 modified "2023-09-27" @default.
• W2070523833 title "Relationship of pulmonary hypertension and right ventricular dysfunction with survival of elderly patients with chronic systolic heart failure" @default.
• W2070523833 doi "https://doi.org/10.1093/eurheartj/eht309.3630" @default.
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