| Elevated pulmonary artery pressure by Doppler echocardiography predicts hospitalization for heart failure and mortality in ambulatory stable coronary artery disease: the Heart and Soul Study. | |
| | |
MedLine Citation:
|
PMID: 17207721 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: We compared the predictive ability of tricuspid regurgitation (TR) and end-diastolic pulmonary regurgitation (EDPR) gradients in outpatients with coronary artery disease. BACKGROUND: The TR and EDPR gradients, in conjunction with right atrial pressure, provide Doppler estimates of pulmonary artery systolic and diastolic pressures. We hypothesized that increases in TR or EDPR gradients in stable coronary artery disease would predict heart failure (HF) hospitalization or cardiovascular (CV) death. METHODS: We measured TR and EDPR gradients in 717 adults with completed outcome adjudications who were recruited for the Heart and Soul Study. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for HF hospitalization, CV death, all-cause death, and the combined end point. Multivariate adjustments were made for age, gender, race, history of CV or pulmonary disease, functional class, and left ventricular ejection fraction. RESULTS: There were 63 HF hospitalizations, 19 CV deaths, and 86 all-cause deaths at the 3-year follow-up. There were 466 measurable EDPR gradients and 573 measurable TR gradients. Age-adjusted ORs for EDPR >5 mm Hg predicted HF hospitalization (2.7, 95% CI 1.3 to 5.5, p = 0.006), all-cause death (2.5, 95% CI 1.4 to 4.4, p = 0.002), and HF hospitalization or CV death (2.7, 95% CI 1.4 to 5.2, p = 0.004). Age-adjusted OR for TR >30 mm Hg predicted HF hospitalization (3.4, 95% CI 1.9 to 6.2, p < 0.0001) and HF hospitalization or CV death (3.0, 95% CI 1.7 to 5.3, p = 0.0001). Multivariate adjusted OR per 5-mm Hg incremental increases in EDPR predicted HF hospitalization or CV death (1.9, 95% CI 1.01 to 3.6, p = 0.046) and all-cause death (1.7, 95% CI 1.05 to 2.8, p = 0.03). Multivariate adjusted OR per 10-mm Hg incremental increases in TR predicted HF hospitalization or CV death (1.6, 95% CI 1.1 to 2.4, p = 0.008). CONCLUSIONS: Increases in EDPR or TR gradients predict HF hospitalization or CV death among ambulatory adults with coronary artery disease. |
| | |
Authors:
|
Bryan Ristow; Sadia Ali; Xiushui Ren; Mary A Whooley; Nelson B Schiller |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. Date: 2006-12-13 |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 49 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2007 Jan |
Date Detail:
|
Created Date: 2007-01-08 Completed Date: 2007-01-30 Revised Date: 2011-10-24 |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 43-9 Citation Subset: AIM; IM |
Affiliation:
|
Department of Medicine, Division of Cardiology, University of California, San Francisco, California, USA. ristowb@medicine.ucsf.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Cardiovascular Diseases / mortality Coronary Artery Disease / mortality* Echocardiography, Doppler Female Heart Failure / therapy* Hospitalization Humans Hypertension / ultrasonography* Male Middle Aged Predictive Value of Tests Pulmonary Artery* Pulmonary Valve Insufficiency / physiopathology, ultrasonography Tricuspid Valve Insufficiency / physiopathology, ultrasonography |
| Grant Support | |
ID/Acronym/Agency:
|
R01 HL079235-01A1/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Influence of blood pressure on the effectiveness of a fixed-dose combination of isosorbide dinitrate...
Next Document: Microvolt T-wave alternans identifies patients with ischemic cardiomyopathy who benefit from implant...