Aortic Pulsatility Index: A New Haemodynamic Measure with Prognostic Value in Advanced Heart Failure
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Aim: To test if the newly described haemodynamic variable, aortic pulsatility index (API), predicts long-term prognosis in advanced heart failure (HF). Methods: A single-centre study on 453 HF patients (median age: 51 years; left ventricular ejection fraction [LVEF]: 19% ± 9%) referred for right heart catheterisation. API was calculated as pulse pressure/pulmonary capillary wedge pressure. Results: Log(API) correlated significantly with central venous pressure (CVP; p<0.001) and cardiac index (p<0.001) in univariable regression analysis. CVP remained associated with log(API) in a multivariable analysis including cardiac index, heart rate, log(NT-proBNP [N-terminal proB-type natriuretic peptide]), LVEF, New York Heart Association (NYHA) class III or IV and sex (p=0.01). In univariable Cox models, log(API) was a significant predictor of freedom from the combined endpoint of death, left ventricular assist device implantation, total artificial heart implantation or heart transplantation (HR 0.33; (95% CI [0.22–0.49]); p<0.001) and all-cause mortality (HR 0.56 (95% CI [0.35–0.90]); p=0.015). After adjusting for age, sex, NYHA class III or IV and estimated glomerular filtration rate in multivariable Cox models, log(API) remained a significant predictor for the combined endpoint (HR 0.33; 95% CI [0.20–0.56]; p<0.001) and all-cause mortality (HR 0.49; 95% CI [0.26–0.96]; p=0.034). Conclusion: API was strongly associated with right-sided filling pressure and independently predicted freedom from the combined endpoint and all-cause mortality.
| Originalsprog | Engelsk |
|---|---|
| Artikelnummer | e18 |
| Tidsskrift | Cardiac Failure Review |
| Vol/bind | 8 |
| Antal sider | 7 |
| ISSN | 2057-7540 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
Disclosure: KR has received fees from Abbott, AstraZeneca, Pfizer, Novartis, Boehringer Ingelheim and Orion Pharma. FG has received research grants from the Novo Nordisk Foundation (grant no NNF20OC0060561) and reports fees from Abbott, AstraZeneca, Pfizer, Novartis, Boehringer Ingelheim, Pharmacosmos, Orion Pharma and Alnylam, and is on the Cardiac Failure Review editorial board; this did not influence peer review. TD has no conflicts of interest to declare. Ethics: The study complies with the Declaration of Helsinki. The research protocol was approved by the local research ethics committee (3-3013-1365/1) and the Data Protection Agency (P-2020-1087). Informed Consent: Individual patient consent was not required due to the retrospective nature of the study. Data Availability: The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available because of privacy or ethical restrictions. Author Contributions: Conception and design: FG, KR, TD. Data extraction and data analysis: TD. All authors made a substantial contribution to interpreting the data and writing the manuscript. All authors reviewed and approved of the final manuscript before submission Received: 27 January 2022 Accepted: 27 February 2022 Citation: Cardiac Failure Review 2022;8:e18. DOI: https://doi.org/10.15420/cfr.2022.09 Correspondence: Finn Gustafsson, Department of Cardiology, Rigshospitalet 2142, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark. E: finn.gustafsson@regionh.dk Open Access: This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.
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© RADCLIFFE CARDIOLOGY 2022
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