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Nonresponse to Acute Vasodilator Challenge and Prognosis in Heart Failure With Pulmonary Hypertension
- Publication Year :
- 2021
-
Abstract
- An acute vasodilator challenge is recommended in patients with heart failure and pulmonary hypertension during heart transplant evaluation. The aim of the study was to assess which hemodynamic parameters are associated with nonresponsiveness to the challenge.This study is a retrospective analysis of 402 patients with heart failure with pulmonary hypertension who underwent right heart catheterization and a pulmonary vasodilator challenge. Among the 140 who fulfilled the transplant guidelines eligibility criteria for the vasodilator challenge, 38 were responders and 102 nonresponders. At multivariable analysis, a diastolic blood pressure of70 mm Hg, pulmonary vascular resistance of5 Woods units, and pulmonary artery compliance of1.2 mL/mm Hg were independently associated with poor response to vasodilator challenge (all P.001). The presence of any 2 of these 3 conditions was associated with a 90% probability of being a nonresponder. The covariate-adjusted hemodynamic predictors of death in the entire population were a low baseline systolic blood pressure (P = .0017) and a low baseline right ventricular stroke work index (P = .0395).In patients with heart failure and pulmonary hypertension, low pulmonary arterial compliance, high pulmonary vascular resistance, and low diastolic blood pressure predict the nonresponsiveness to acute vasodilator challenge whilst a poor right ventricular function predicts a dismal prognosis.
- Subjects :
- medicine.medical_specialty
Cardiac Catheterization
left heart disease
Pulmonary hypertension
pulmonary vascular disease
Hypertension, Pulmonary
Vasodilator Agents
Hemodynamics
Vasodilation
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine.artery
medicine
Humans
030212 general & internal medicine
Retrospective Studies
Heart Failure
business.industry
medicine.disease
Prognosis
Compliance (physiology)
Blood pressure
medicine.anatomical_structure
Heart failure
Pulmonary artery
Vascular resistance
Cardiology
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....c5ac1e7b39bcf301d822778a98ef10c0