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Ni J, Fang Y, Zhang J, Chen X. Predicting prognosis of heart failure using common malnutrition assessment tools: A systematic review and meta-analysis. Scott Med J 2022; 67:157-170. [PMID: 36052423 DOI: 10.1177/00369330221122300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS COUNT score, PNI score, and GNRI scores are associated with cardiovascular events. This review identifies the most accurate malnutrition assessment tools based on these scores in predicting mortality and readmission outcomes in HF patients. MATERIAL AND METHODS PubMed via MEDLINE, EMBASE were searched to identify studies assessing malnutrition using CONUT, PNI and GNRI. A meta-analysis was carried out to pool the hazard ratios on mortality and readmission rates. The methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS The mortality in HF patients with malnutrition assessed by CONUT showed pooled HR of 1.23. HF patients with all severe, moderate, and mild risk of malnutrition showed mortality with HR 3.56, 2.71 and 1.57 respectively. For malnutrition assessed with GNRI, HF patients with all severe, moderate, and mild risk of malnutrition showed mortality with HR 4.17, 2.73 and 1.73 respectively. No significance difference in association of CONUT score with pooled HR of readmission rate was observed HR 0.99. With PNI, HF patients with all severe and moderate risk of malnutrition showed mortality with HR 2.14 and HR 1.68 respectively, although they failed to achieve significance. CONCLUSION CONUT and GNRI are the superior prognostic indicator than PNI in prediction of mortality associated with risk of malnutrition.
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Affiliation(s)
- Jianchao Ni
- Department of Geriatrics, 223524Affiliated Hospital of Shaoxing University, Shaoxing City, China
| | - Yuanyuan Fang
- Department of Geriatrics, 223524Affiliated Hospital of Shaoxing University, Shaoxing City, China
| | - Jianhai Zhang
- Department of Geriatrics, 223524Affiliated Hospital of Shaoxing University, Shaoxing City, China
| | - Xiaoyan Chen
- Department of General Physician, 74784Zhuji People's Hospital of Zhejiang Province, Zhuji, China
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Calò L, Capucci A, Santini L, Pecora D, Favale S, Petracci B, Molon G, Bianchi V, Cipolletta L, De Ruvo E, Ammirati F, La Greca C, Campari M, Valsecchi S, D’Onofrio A. ICD-measured heart sounds and their correlation with echocardiographic indexes of systolic and diastolic function. J Interv Card Electrophysiol 2020; 58:95-101. [DOI: 10.1007/s10840-019-00668-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022]
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AlHabeeb W, Al-Ayoubi F, AlGhalayini K, Al Ghofaili F, Al Hebaishi Y, Al-Jazairi A, Al-Mallah MH, AlMasood A, Al Qaseer M, Al-Saif S, Chaudhary A, Elasfar A, Tash A, Arafa M, Hassan W. Saudi Heart Association (SHA) guidelines for the management of heart failure. J Saudi Heart Assoc 2019; 31:204-253. [PMID: 31371908 PMCID: PMC6660461 DOI: 10.1016/j.jsha.2019.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 05/31/2019] [Accepted: 06/18/2019] [Indexed: 12/11/2022] Open
Abstract
Heart failure (HF) is the leading cause of morbidity and mortality worldwide and negatively impacts quality of life, healthcare costs, and longevity. Although data on HF in the Arab population are scarce, recently developed regional registries are a step forward to evaluating the quality of current patient care and providing an overview of the clinical picture. Despite the burden of HF in Saudi Arabia, there are currently no standardized protocols or guidelines for the management of patients with acute or chronic heart failure. Therefore, the Heart Failure Expert Committee, comprising 13 local specialists representing both public and private sectors, has developed guidelines to address the needs and challenges for the diagnosis and treatment of HF in Saudi Arabia. The ultimate aim of these guidelines is to assist healthcare professionals in delivering optimal care and standardized clinical practice across Saudi Arabia.
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Affiliation(s)
- Waleed AlHabeeb
- Cardiac Sciences Department, King Saud University, Riyadh, Saudi ArabiaSaudi Arabia
- Corresponding author at: Cardiac Sciences Department, King Saud University, P.O. Box 7805, Riyadh 11472, Saudi Arabia.
| | - Fakhr Al-Ayoubi
- King Fahad Cardiac Center, King Saud University, Riyadh, Saudi ArabiaSaudi Arabia
| | - Kamal AlGhalayini
- King Abdulaziz University Hospital, Jeddah, Saudi ArabiaSaudi Arabia
| | - Fahad Al Ghofaili
- King Salman Heart Center, King Fahad Medical City, Riyadh, Saudi ArabiaSaudi Arabia
| | | | - Abdulrazaq Al-Jazairi
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi ArabiaSaudi Arabia
| | - Mouaz H. Al-Mallah
- King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Cardiac Center, Ministry of National Guard, Health Affairs, Riyadh, Saudi ArabiaSaudi Arabia
| | - Ali AlMasood
- Riyadh Care Hospital, Riyadh, Saudi ArabiaSaudi Arabia
| | - Maryam Al Qaseer
- King Fahad Specialist Hospital, Dammam, Saudi ArabiaSaudi Arabia
| | - Shukri Al-Saif
- Saud Al-Babtain Cardiac Center, Dammam, Saudi ArabiaSaudi Arabia
| | - Ammar Chaudhary
- King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi ArabiaSaudi Arabia
| | - Abdelfatah Elasfar
- Madina Cardiac Center, AlMadina AlMonaoarah, Saudi ArabiaSaudi Arabia
- Cardiology Department, Tanta University, EgyptEgypt
| | - Adel Tash
- Ministry of Health, Riyadh, Saudi ArabiaSaudi Arabia
| | - Mohamed Arafa
- Cardiac Sciences Department, King Saud University, Riyadh, Saudi ArabiaSaudi Arabia
| | - Walid Hassan
- International Medical Center, Jeddah, Saudi ArabiaSaudi Arabia
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4
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Wallner M, Khafaga M, Kolesnik E, Vafiadis A, Schwantzer G, Eaton DM, Curcic P, Köstenberger M, Knez I, Rainer PP, Pichler M, Pieske B, Lewinski DV. Istaroxime, a potential anticancer drug in prostate cancer, exerts beneficial functional effects in healthy and diseased human myocardium. Oncotarget 2017; 8:49264-49274. [PMID: 28514771 PMCID: PMC5564766 DOI: 10.18632/oncotarget.17540] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 04/14/2017] [Indexed: 12/28/2022] Open
Abstract
The current gold standard for prostate cancer treatment is androgen deprivation therapy and antiandrogenic agents. However, adverse cardiovascular events including heart failure can limit therapeutic use. Istaroxime, which combines Na+-K+-ATPase (NKA) inhibition with sarco/endoplasmic reticulum Ca2+-ATPase 2a (SERCA2a) stimulation, has recently shown promising anti-neoplastic effects in prostate cancer (PC) models and may also improve cardiac function. Considering the promising anticancer effects of istaroxime, we aimed to assess its functional effects on human myocardium.
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Affiliation(s)
- Markus Wallner
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.,Cardiovascular Research Center, Lewis Katz School of Medicine, Temple University, Philadelphia, 19140 PA, United States of America
| | - Mounir Khafaga
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Ewald Kolesnik
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Aris Vafiadis
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Gerold Schwantzer
- Institute for Medical Informatics, Statistics, and Documentation, Medical University of Graz, 8036 Graz, Austria
| | - Deborah M Eaton
- Cardiovascular Research Center, Lewis Katz School of Medicine, Temple University, Philadelphia, 19140 PA, United States of America
| | - Pero Curcic
- Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
| | - Martin Köstenberger
- Department of Pediatric Cardiology, Medical University of Graz, 8036 Graz, Austria
| | - Igor Knez
- Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria
| | - Peter P Rainer
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Martin Pichler
- Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
| | - Burkert Pieske
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.,Department of Internal Medicine and Cardiology, Campus Virchow Klinikum, Charité University Medicine, Berlin, 13353 Berlin, Germany.,Department of Internal Medicine and Cardiology, German Heart Center, Berlin, 13353 Berlin, Germany
| | - Dirk Von Lewinski
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria
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5
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Thakur PH, An Q, Swanson L, Zhang Y, Gardner RS. Haemodynamic monitoring of cardiac status using heart sounds from an implanted cardiac device. ESC Heart Fail 2017; 4:605-613. [PMID: 29154421 PMCID: PMC5695191 DOI: 10.1002/ehf2.12171] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/17/2017] [Accepted: 05/23/2017] [Indexed: 11/11/2022] Open
Abstract
AIM The aim of this study was to evaluate the haemodynamic correlates of heart sound (HS) parameters such as third HS (S3), first HS (S1), and HS-based systolic time intervals (HSTIs) from an implantable cardiac device. METHODS AND RESULTS Two unique animal models (10 swine with myocardial ischaemia and 11 canines with pulmonary oedema) were used to evaluate haemodynamic correlates of S1, S3, and HSTIs, namely, HS-based pre-ejection period (HSPEP), HS-based ejection time (HSET), and the ratio HSPEP/HSET during acute haemodynamic perturbations. The HS was measured using implanted cardiac resynchronization therapy defibrillator devices simultaneously with haemodynamic references such as left atrial (LA) pressure and left ventricular (LV) pressure. In the ischaemia model, S1 amplitude (r = 0.76 ± 0.038; P = 0.002), HSPEP (r = -0.56 ± 0.07; P = 0.002), and HSPEP/HSET (r = -0.42 ± 0.1; P = 0.002) were significantly correlated with LV dP/dtmax . In contrast, HSET was poorly correlated with LV dP/dtmax (r = 0.14 ± 0.14; P = 0.23). In the oedema model, a physiological delayed response was observed in S3 amplitude after acute haemodynamic perturbations. After adjusting for the delay, S3 amplitude significantly correlated with LA pressure in individual animals (r = 0.71 ± 0.07; max: 0.92; min: 0.17) as well as in aggregate (r = 0.62; P < 0.001). The S3 amplitude was able to detect elevated LA pressure, defined as >25 mmHg, with a sensitivity = 58% and specificity = 90%. CONCLUSIONS The HS parameters such as S1, S3, and HSTIs measured using implantable devices significantly correlated with haemodynamic changes in acute animal models, suggesting potential utility for remote heart failure patient monitoring.
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Affiliation(s)
| | - Qi An
- Boston Scientific, St Paul, Minnesota, USA
| | | | - Yi Zhang
- Boston Scientific, St Paul, Minnesota, USA
| | - Roy S Gardner
- Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Clydebank, UK
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Bipat R, Toelsie JR, Magali I, Soekhoe R, Stender K, Wangsawirana A, Oedairadjsingh K, Pawirodihardjo J, Mans DRA. Beneficial effect of medicinal plants on the contractility of post-hypoxic isolated guinea pig atria - Potential implications for the treatment of ischemic-reperfusion injury. PHARMACEUTICAL BIOLOGY 2016; 54:1483-1489. [PMID: 26730936 DOI: 10.3109/13880209.2015.1107103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Context Ischemic-reperfusion injury is accompanied by a decreased contractility of the myocardium. Positive-inotropic agents have proven useful for treating this condition but may exert serious side-effects. Objective In this study, aqueous preparations from Abelmoschus esculentus L. Moench (Malvaceae), Annona muricata L. (Annonaceae), Bixa orellana L. (Bixaceae), Cecropia peltata L. (Moraceae), Erythrina fusca Lour. (Fabaceae), Psidium guajava L. (Myrtaceae) and Terminalia catappa L. (Combretaceae) were evaluated for their ability to improve the decreased contractility of isolated guinea pig atria after hypoxic stress. Materials and methods Guinea pig atria isolated in Ringer-Locke buffer gassed with 100% O2 at 30 °C were exposed for 5 min to hypoxia, then allowed to recover in oxygenated buffer alone or containing a single plant extract (0.001-1 mg/mL). The contractility (g/s) and beating frequency (beats/min), as well as troponin C contents of the bathing solution (ng/mL), were determined and expressed as means ± SDs. Results The extracts of A. muricata, B. orellana, C. peltata and T. catappa caused an increase in the contractility compared to untreated atria of 340 ± 102%, 151 ± 13%, 141 ± 14% and 238 ± 44%, respectively. However, the latter two preparations increased the troponin C contents of the bathing solution to 36 ± 11 and 69 ± 33, compared to the value of 11 ± 3 ng/mL found with untreated atria. Conclusions Preparations from A. muricata and B. orellana may possess positive-inotropic properties which may improve the contractility of the post-hypoxic myocardium. Studies to assess their usefulness in ischemic-reperfusion injury are warranted.
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Affiliation(s)
- Robbert Bipat
- a Department of Physiology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
| | - Jerry R Toelsie
- a Department of Physiology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
| | - Indira Magali
- a Department of Physiology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
- b Department of Pharmacology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
| | - Rubaina Soekhoe
- a Department of Physiology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
- b Department of Pharmacology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
| | - Karin Stender
- c Department of Pharmacy , University of Utrecht , Utrecht , The Netherlands
| | - Angelique Wangsawirana
- d Department of Clinical Chemistry , University of Groningen , Groningen , The Netherlands
| | - Krishan Oedairadjsingh
- a Department of Physiology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
- b Department of Pharmacology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
| | - Jennifer Pawirodihardjo
- a Department of Physiology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
- b Department of Pharmacology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
| | - Dennis R A Mans
- b Department of Pharmacology, Faculty of Medical Sciences , Anton de Kom University of Suriname , Paramaribo , Suriname
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Nánási P, Váczi K, Papp Z. The myosin activator omecamtiv mecarbil: a promising new inotropic agent. Can J Physiol Pharmacol 2016; 94:1033-1039. [PMID: 27322915 DOI: 10.1139/cjpp-2015-0573] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Heart failure became a leading cause of mortality in the past few decades with a progressively increasing prevalence. Its current therapy is restricted largely to the suppression of the sympathetic activity and the renin-angiotensin system in combination with diuretics. This restrictive strategy is due to the potential long-term adverse effects of inotropic agents despite their effective influence on cardiac function when employed for short durations. Positive inotropes include inhibitors of the Na+/K+ pump, β-receptor agonists, and phosphodiesterase inhibitors. Theoretically, Ca2+ sensitizers may also increase cardiac contractility without resulting in Ca2+ overload; nevertheless, their mechanism of action is frequently complicated by other pleiotropic effects. Recently, a new positive inotropic agent, the myosin activator omecamtiv mecarbil, has been developed. Omecamtiv mecarbil binds directly to β-myosin heavy chain and enhances cardiac contractility by increasing the number of the active force-generating cross-bridges, presumably without major off-target effects. This review focuses on recent in vivo and in vitro results obtained with omecamtiv mecarbil, and discusses its mechanism of action at a molecular level. Based on clinical data, omecamtiv mecarbil is a promising new tool in the treatment of systolic heart failure.
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Affiliation(s)
- Péter Nánási
- a Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Krisztina Váczi
- b Department of Physiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zoltán Papp
- c Division of Clinical Physiology, Department of Cardiology, Research Center for Molecular Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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8
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Gheorghiade M, Vaduganathan M, Ambrosy A, Böhm M, Campia U, Cleland JGF, Fedele F, Fonarow GC, Maggioni AP, Mebazaa A, Mehra M, Metra M, Nodari S, Pang PS, Ponikowski P, Sabbah HN, Komajda M, Butler J. Current management and future directions for the treatment of patients hospitalized for heart failure with low blood pressure. Heart Fail Rev 2013; 18:107-22. [PMID: 22581217 DOI: 10.1007/s10741-012-9315-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Although patients hospitalized with heart failure have relatively low in-hospital mortality, the post-discharge rehospitalization and mortality rates remain high despite advances in treatment. Most patients admitted for heart failure have normal or high blood pressure, but 15-25 % have low systolic blood pressure with or without signs and/or symptoms of hypoperfusion. All pharmacological agents known to improve the prognosis of patients with heart failure also reduce blood pressure, and this limits their use in patients with heart failure and low blood pressure (HF-LBP). However, patients with HF-LBP have much higher in-hospital and post-discharge mortality. In these patients, a conceptually important therapeutic target is to improve cardiac output in order to alleviate signs of hypoperfusion. Accordingly, the majority of these patients will require an inotrope as cardiac dysfunction is the cause of their low cardiac output. However, the short-term use of currently available inotropes has been associated with further decreases in blood pressure and increases in heart rate, myocardial oxygen consumption and arrhythmias. Agents that improve cardiac contractility without this undesirable effects should be developed. To the best of our knowledge, the epidemiology, pathophysiology and therapy of patients with HF-LBP have not been addressed thoroughly. In June 2010, a workshop that included scientists and clinicians was held in Rome, Italy. The objectives of this meeting were to (1) develop a working definition for HF-LBP, (2) describe its clinical characteristics and pathophysiology, (3) review current therapies and their limitations, (4) discuss novel agents in development and (5) create a framework for the design and conduct of future clinical trials.
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Affiliation(s)
- Mihai Gheorghiade
- Center of Cardiovascular Innovation, Northwestern University Feinberg School of Medicine, 645 North Michigan Ave, Suite 1006, Chicago, IL 60611, USA.
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9
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Maekawa E, Inomata T, Watanabe I, Yanagisawa T, Mizutani T, Shinagawa H, Koitabashi T, Takeuchi I, Tokita N, Inoue Y, Izumi T. Prognostic significance of right ventricular dimension on acute decompensation in chronic left-sided heart failure. Int Heart J 2011; 52:119-26. [PMID: 21483173 DOI: 10.1536/ihj.52.119] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Right ventricular (RV) dysfunction has been discussed in relation to an adverse outcome in heart failure (HF). The aim of this study was to analyze the relationship between RV function with HF exacerbation and its subsequent long-term outcome in patients with chronic left-sided HF.We studied 122 consecutive patients who were admitted for dyspnea due to exacerbated left-sided HF with a left ventricular (LV) ejection fraction of less than 40%. Conventional echocardiography was performed in the study subjects on admission and at discharge. Cox proportional hazards analysis revealed that RV end-diastolic dimension (RVDd) (hazard ratio 1.131, P = 0.005, 95% confidence interval 1.039-1.231) and the serum level of creatinine on admission were independent predictors of subsequent cardiac-related death, but RVDd at discharge and other LV parameters were not. Thus, patients were divided into tertiles on the basis of RVDd on admission: < 32 mm (n = 37), 32-40 mm (n = 43), and ≥ 40 mm (n = 42). According to the increase in the RVDd category, the cardiac-related death-free rate significantly decreased. Among the 3 groups, the pulse pressure and serum total bilirubin levels that demonstrated low cardiac output syndrome (LOS) parameters had significant differences.RVDd on admission could be measured noninvasively and easily to predict a worse long-term prognosis of chronic left-sided HF on admission, and showed correlations with LOS parameters.
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Affiliation(s)
- Emi Maekawa
- Department of Cardio-Angiology, Kitasato University School of Medicine
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