Prognostic Role of Subclinical Congestion in Heart Failure Outpatients: Focus on Right Ventricular Dysfunction

Background: subclinical pulmonary and peripheral congestion is an emerging concept in heart failure, correlated with a worse prognosis. Very few studies have evaluated its prognostic impact in an outpatient setting and its relationship with right-ventricular dysfunction. The study aims to investigat...

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Autores principales:	Andrea Lorenzo Vecchi, Silvia Muccioli, Jacopo Marazzato, Antonella Mancinelli, Attilio Iacovoni, Roberto De Ponti
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	subclinical congestion heart failure right ventricular dysfunction right ventricular/arterial coupling Medicine R
Acceso en línea:	https://doaj.org/article/17423ad0fc3a4442abf10e0109e46c74
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spelling	oai:doaj.org-article:17423ad0fc3a4442abf10e0109e46c742021-11-25T18:02:40ZPrognostic Role of Subclinical Congestion in Heart Failure Outpatients: Focus on Right Ventricular Dysfunction10.3390/jcm102254232077-0383https://doaj.org/article/17423ad0fc3a4442abf10e0109e46c742021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5423https://doaj.org/toc/2077-0383Background: subclinical pulmonary and peripheral congestion is an emerging concept in heart failure, correlated with a worse prognosis. Very few studies have evaluated its prognostic impact in an outpatient setting and its relationship with right-ventricular dysfunction. The study aims to investigate subclinical congestion in chronic heart failure outpatients, exploring the close relationship between the right heart-pulmonary unit and peripheral congestion. Materials and methods: in this observational study, 104 chronic HF outpatients were enrolled. The degree of congestion and signs of elevated filling pressures of the right ventricle were evaluated by physical examination and a transthoracic ultrasound to define multiparametric right ventricular dysfunction, estimate the right atrial pressure and the pulmonary artery systolic pressure. Outcome data were obtained by scheduled visits and phone calls. Results: ultrasound signs of congestion were found in 26% of patients and, among this cohort, half of them presented as subclinical, affecting their prognosis, revealing a linear correlation between right ventricular/arterial coupling, the right-chambers size and ultrasound congestion. Right ventricular dysfunction, TAPSE/PAPS ratio, clinical and ultrasound signs of congestion have been confirmed to be useful predictors of outcome. Conclusions: subclinical congestion is widespread in the heart failure outpatient population, significantly affecting prognosis, especially when right ventricular dysfunction also occurs, suggesting a strict correlation between the heart-pulmonary unit and volume overload.Andrea Lorenzo VecchiSilvia MuccioliJacopo MarazzatoAntonella MancinelliAttilio IacovoniRoberto De PontiMDPI AGarticlesubclinical congestionheart failureright ventricular dysfunctionright ventricular/arterial couplingMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5423, p 5423 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	subclinical congestion heart failure right ventricular dysfunction right ventricular/arterial coupling Medicine R
spellingShingle	subclinical congestion heart failure right ventricular dysfunction right ventricular/arterial coupling Medicine R Andrea Lorenzo Vecchi Silvia Muccioli Jacopo Marazzato Antonella Mancinelli Attilio Iacovoni Roberto De Ponti Prognostic Role of Subclinical Congestion in Heart Failure Outpatients: Focus on Right Ventricular Dysfunction
description	Background: subclinical pulmonary and peripheral congestion is an emerging concept in heart failure, correlated with a worse prognosis. Very few studies have evaluated its prognostic impact in an outpatient setting and its relationship with right-ventricular dysfunction. The study aims to investigate subclinical congestion in chronic heart failure outpatients, exploring the close relationship between the right heart-pulmonary unit and peripheral congestion. Materials and methods: in this observational study, 104 chronic HF outpatients were enrolled. The degree of congestion and signs of elevated filling pressures of the right ventricle were evaluated by physical examination and a transthoracic ultrasound to define multiparametric right ventricular dysfunction, estimate the right atrial pressure and the pulmonary artery systolic pressure. Outcome data were obtained by scheduled visits and phone calls. Results: ultrasound signs of congestion were found in 26% of patients and, among this cohort, half of them presented as subclinical, affecting their prognosis, revealing a linear correlation between right ventricular/arterial coupling, the right-chambers size and ultrasound congestion. Right ventricular dysfunction, TAPSE/PAPS ratio, clinical and ultrasound signs of congestion have been confirmed to be useful predictors of outcome. Conclusions: subclinical congestion is widespread in the heart failure outpatient population, significantly affecting prognosis, especially when right ventricular dysfunction also occurs, suggesting a strict correlation between the heart-pulmonary unit and volume overload.
format	article
author	Andrea Lorenzo Vecchi Silvia Muccioli Jacopo Marazzato Antonella Mancinelli Attilio Iacovoni Roberto De Ponti
author_facet	Andrea Lorenzo Vecchi Silvia Muccioli Jacopo Marazzato Antonella Mancinelli Attilio Iacovoni Roberto De Ponti
author_sort	Andrea Lorenzo Vecchi
title	Prognostic Role of Subclinical Congestion in Heart Failure Outpatients: Focus on Right Ventricular Dysfunction
title_short	Prognostic Role of Subclinical Congestion in Heart Failure Outpatients: Focus on Right Ventricular Dysfunction
title_full	Prognostic Role of Subclinical Congestion in Heart Failure Outpatients: Focus on Right Ventricular Dysfunction
title_fullStr	Prognostic Role of Subclinical Congestion in Heart Failure Outpatients: Focus on Right Ventricular Dysfunction
title_full_unstemmed	Prognostic Role of Subclinical Congestion in Heart Failure Outpatients: Focus on Right Ventricular Dysfunction
title_sort	prognostic role of subclinical congestion in heart failure outpatients: focus on right ventricular dysfunction
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/17423ad0fc3a4442abf10e0109e46c74
work_keys_str_mv	AT andrealorenzovecchi prognosticroleofsubclinicalcongestioninheartfailureoutpatientsfocusonrightventriculardysfunction AT silviamuccioli prognosticroleofsubclinicalcongestioninheartfailureoutpatientsfocusonrightventriculardysfunction AT jacopomarazzato prognosticroleofsubclinicalcongestioninheartfailureoutpatientsfocusonrightventriculardysfunction AT antonellamancinelli prognosticroleofsubclinicalcongestioninheartfailureoutpatientsfocusonrightventriculardysfunction AT attilioiacovoni prognosticroleofsubclinicalcongestioninheartfailureoutpatientsfocusonrightventriculardysfunction AT robertodeponti prognosticroleofsubclinicalcongestioninheartfailureoutpatientsfocusonrightventriculardysfunction
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Prognostic Role of Subclinical Congestion in Heart Failure Outpatients: Focus on Right Ventricular Dysfunction

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