Right ventricular diameter predicts all-cause mortality in heart failure with preserved ejection fraction

AbstractLeft ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) phenotype in clinical practice. The aim of the study was to identify simple echocardiographic predictors of post-discharge all-cause mortality in hospitalized HF patients. Patients with acute HF (75  ± 9.8 years), classified in preserved (≥ 50%) and reduced (<  50%) EF (HFpEF and HFrEF, respectively), were enrolled. The mean follow-up period was of 25.4 months. Patients definitively analyzed were 135. At multivariate Cox model, right ventricular diameter (RVd), inferior vena cava diameter (IVCd) and blood urea nitrogen (BUN) resulted to be significantl y associated with all-cause mortality in HFpEF (HR 2.4,p = 0.04; HR 1.06,p = 0.02; HR 1.02,p = 0.01), whereas, left atrial volume (LAV) was significantly associated with mortality in HFrEF (HR 1.06,p = 0.006). Excluding LAV from the model, only COPD remained an independent predictor of all-cause mortality (HR 2.15,p = 0.04) in HFrEF. At Kaplan–Meier analysis, no differences of survival between HFrEF and HFpEF were found, however, significantly increased all-cause mortality for higher values of basal-RVd, BUN, and IVCd (log-rankp = 0.0065, 0.0063, 0.0005) in HFpEF, and for COPD and higher LAV (log-rankp = 0.0046,p = 0.033) in HFrEF. These data are indicative that in patients hospitalized with HF, EF is not a suitable predictor of long-term all-cause mortality, whereas, right ventricular...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research