Cardiac index predicts long-term outcomes in patients with heart failure.

<h4>Background</h4>The role of cardiac index (CI) and right atrial pressure (RAP) for predicting long-term outcomes of heart failure has not been well established. The aim of this study was to investigate long-term cardiac outcomes in patients with heart failure having various combinatio...

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Autores principales:	Tatsuro Ibe, Hiroshi Wada, Kenichi Sakakura, Yusuke Ugata, Hisataka Maki, Kei Yamamoto, Masaru Seguchi, Yousuke Taniguchi, Hiroyuki Jinnouchi, Hideo Fujita
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3690ae4948794c6c8de152346d6dd5d0
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spelling	oai:doaj.org-article:3690ae4948794c6c8de152346d6dd5d02021-12-02T20:07:14ZCardiac index predicts long-term outcomes in patients with heart failure.1932-620310.1371/journal.pone.0252833https://doaj.org/article/3690ae4948794c6c8de152346d6dd5d02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0252833https://doaj.org/toc/1932-6203<h4>Background</h4>The role of cardiac index (CI) and right atrial pressure (RAP) for predicting long-term outcomes of heart failure has not been well established. The aim of this study was to investigate long-term cardiac outcomes in patients with heart failure having various combinations of CI and RAP.<h4>Methods</h4>A total of 787 heart failure patients who underwent right-heart catheterization were retrospectively categorized into the following four groups: Preserved CI (≥2.5 L/min/m2) and Low RAP (<8 mmHg) (PRE-CI/L-RAP; n = 285); Preserved CI (≥2.5 L/min/m2) and High RAP (≥8 mmHg) (PRE-CI/H-RAP; n = 242); Reduced CI (<2.5 L/min/m2) and Low RAP (<8 mmHg) (RED-CI/L-RAP; n = 123); and Reduced CI (<2.5 L/min/m2) and High RAP (≥8 mmHg) (RED-CI/H-RAP; n = 137). Survival analysis was applied to investigate which groups were associated with major adverse cardiovascular events (MACE).<h4>Results</h4>The RED-CI/L-RAP and RED-CI/H-RAP groups were significantly associated with MACE as compared with the PRE-CI/L-RAP and PRE-CI/H-RAP groups after adjustment for confounding factors (RED-CI/L-RAP vs. PRE-CI/L-RAP: HR 2.11 [95% CI 1.33-3.37], p = 0.002; RED-CI/H-RAP vs. PRE-CI/L-RAP: HR 2.18 [95% CI 1.37-3.49], p = 0.001; RED-CI/L-RAP vs. PRE-CI/H-RAP: HR 1.86 [95% CI 1.16-3.00], p = 0.01; RED-CI/H-RAP vs. PRE-CI/H-RAP: HR 1.92 [95% CI 1.26-2.92], p = 0.002), whereas the difference between the RED-CI/H-RAP and RED-CI/L-RAP groups was not significant (HR 1.03 [95% CI 0.64-1.66], p = 0.89).<h4>Conclusions</h4>The hemodynamic severity categorized by CI and RAP levels provided clear risk stratification in patients with symptomatic heart failure. Low CI was an independent predictor of long-term cardiac outcomes.Tatsuro IbeHiroshi WadaKenichi SakakuraYusuke UgataHisataka MakiKei YamamotoMasaru SeguchiYousuke TaniguchiHiroyuki JinnouchiHideo FujitaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0252833 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tatsuro Ibe Hiroshi Wada Kenichi Sakakura Yusuke Ugata Hisataka Maki Kei Yamamoto Masaru Seguchi Yousuke Taniguchi Hiroyuki Jinnouchi Hideo Fujita Cardiac index predicts long-term outcomes in patients with heart failure.
description	<h4>Background</h4>The role of cardiac index (CI) and right atrial pressure (RAP) for predicting long-term outcomes of heart failure has not been well established. The aim of this study was to investigate long-term cardiac outcomes in patients with heart failure having various combinations of CI and RAP.<h4>Methods</h4>A total of 787 heart failure patients who underwent right-heart catheterization were retrospectively categorized into the following four groups: Preserved CI (≥2.5 L/min/m2) and Low RAP (<8 mmHg) (PRE-CI/L-RAP; n = 285); Preserved CI (≥2.5 L/min/m2) and High RAP (≥8 mmHg) (PRE-CI/H-RAP; n = 242); Reduced CI (<2.5 L/min/m2) and Low RAP (<8 mmHg) (RED-CI/L-RAP; n = 123); and Reduced CI (<2.5 L/min/m2) and High RAP (≥8 mmHg) (RED-CI/H-RAP; n = 137). Survival analysis was applied to investigate which groups were associated with major adverse cardiovascular events (MACE).<h4>Results</h4>The RED-CI/L-RAP and RED-CI/H-RAP groups were significantly associated with MACE as compared with the PRE-CI/L-RAP and PRE-CI/H-RAP groups after adjustment for confounding factors (RED-CI/L-RAP vs. PRE-CI/L-RAP: HR 2.11 [95% CI 1.33-3.37], p = 0.002; RED-CI/H-RAP vs. PRE-CI/L-RAP: HR 2.18 [95% CI 1.37-3.49], p = 0.001; RED-CI/L-RAP vs. PRE-CI/H-RAP: HR 1.86 [95% CI 1.16-3.00], p = 0.01; RED-CI/H-RAP vs. PRE-CI/H-RAP: HR 1.92 [95% CI 1.26-2.92], p = 0.002), whereas the difference between the RED-CI/H-RAP and RED-CI/L-RAP groups was not significant (HR 1.03 [95% CI 0.64-1.66], p = 0.89).<h4>Conclusions</h4>The hemodynamic severity categorized by CI and RAP levels provided clear risk stratification in patients with symptomatic heart failure. Low CI was an independent predictor of long-term cardiac outcomes.
format	article
author	Tatsuro Ibe Hiroshi Wada Kenichi Sakakura Yusuke Ugata Hisataka Maki Kei Yamamoto Masaru Seguchi Yousuke Taniguchi Hiroyuki Jinnouchi Hideo Fujita
author_facet	Tatsuro Ibe Hiroshi Wada Kenichi Sakakura Yusuke Ugata Hisataka Maki Kei Yamamoto Masaru Seguchi Yousuke Taniguchi Hiroyuki Jinnouchi Hideo Fujita
author_sort	Tatsuro Ibe
title	Cardiac index predicts long-term outcomes in patients with heart failure.
title_short	Cardiac index predicts long-term outcomes in patients with heart failure.
title_full	Cardiac index predicts long-term outcomes in patients with heart failure.
title_fullStr	Cardiac index predicts long-term outcomes in patients with heart failure.
title_full_unstemmed	Cardiac index predicts long-term outcomes in patients with heart failure.
title_sort	cardiac index predicts long-term outcomes in patients with heart failure.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/3690ae4948794c6c8de152346d6dd5d0
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Cardiac index predicts long-term outcomes in patients with heart failure.

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