1. Association between right-sided cardiac function and ultrasound-based pulmonary congestion on acutely decompensated heart failure findings from a pooled analysis of four cohort studies
- Author
-
Kevin Duarte, Pierpaolo Pellicori, Luna Gargani, Josep Lupón, Stefano Coiro, Gaetano Ruocco, Patrick Rossignol, Nicola Riccardo Pugliese, Masatake Kobayashi, Giuseppe Ambrosio, Nicolas Girerd, Olivier Huttin, Antoni Bayes-Genis, Alberto Palazzuoli, Yogesh N.V. Reddy, Centre d'investigation clinique plurithématique Pierre Drouin [Nancy] (CIC-P), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], French-Clinical Research Infrastructure Network - F-CRIN [Paris] (Cardiovascular & Renal Clinical Trialists - CRCT ), Institute of Clinical Physiology, section of Pisa, Consiglio Nazionale delle Ricerche [Roma] (CNR), Cardiovascular Diseases Unit Department of Internal Medicine, University of Siena, Division of Cardiology, University of Perugia School of Medicine, Perugia, Department of Medicine, Autonomous University of Barcelona, Badalona, Spain., Robertson Centre for Biostatistics and Clinical Trials, University of Glasgow and National Heart & Lung Institute, Department of Clinical and Experimental Medicine, University of Pisa, Department of Cardiovascular Medicine, Mayo Clinic, Cardiology Division, Regina Montis Regalis Hospital, ASL CN-1, Mondovì, MK is granted by the RHU Fight-HF, a public grant overseen by the French National Research Agency (ANR) as part of the second 'Investissements d’Avenir' program (ANR-15-RHUS-0004). PR, NG and KD are supported by the RHU Fight-HF, a public grant overseen by the French National Research Agency (ANR) as part of the second 'Investissements d’Avenir' program (ANR-15-RHUS-0004) and by the FrenchPIA project 'Lorraine Université d’Excellence' (ANR-15-IDEX-04-LUE)., ANR-15-RHUS-0004,FIGHT-HF,Combattre l'insuffisance cardiaque(2015), and ANR-15-IDEX-0004,LUE (ISITE),Lorraine Université d'Excellence(2016)
- Subjects
Male ,Cardiac function curve ,medicine.medical_specialty ,Hypertension, Pulmonary ,Ventricular Dysfunction, Right ,Hemodynamics ,Right heart ,Acutely decompensated heart failure ,Pulmonary Artery ,030204 cardiovascular system & hematology ,Pulmonary congestion ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,medicine.artery ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Ultrasonography ,Heart Failure ,Lung ultrasound ,Ejection fraction ,business.industry ,Diastolic heart failure ,Stroke Volume ,Cardiac edema ,General Medicine ,Prognosis ,medicine.disease ,3. Good health ,Blood pressure ,medicine.anatomical_structure ,Heart failure ,Pulmonary artery ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Right ventricular (RV) dysfunction and RV–pulmonary artery (PA) uncoupling are associated with the development of pulmonary congestion during exercise. However, there is limited information regarding the association between these right-sided cardiac parameters and pulmonary congestion in acutely decompensated heart failure (HF). We performed an individual patient meta-analysis from four cohort studies of hospitalized patients with HF who had available lung ultrasound (B-lines) data on admission and/or at discharge. RV function was assessed by tricuspid annular plane systolic excursion (TAPSE), RV–PA coupling was defined as the ratio of TAPSE to PA systolic pressure (PASP). Admission and discharge cohort included 319 patients (75.8 ± 10.1 years, 46% women) and 221 patients (77.9 ± 9.0 years, 47% women), respectively. Overall, higher TAPSE was associated with higher ejection fraction, lower PASP, b-type natriuretic peptide and B-line counts. By multivariable analysis, worse RV function or RV–PA coupling was associated with higher B-line counts on admission and at discharge, and with a less reduction in B-line counts from admission to discharge. Higher B-line counts at discharge were associated with a higher risk of the composite of all-cause mortality and/or HF re-hospitalization [adjusted-HR 1.13 (1.09–1.16), p
- Published
- 2021