| Response of the right ventricle to acute pulmonary vasodilation predicts the outcome in patients with advanced heart failure and pulmonary hypertension. | |
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MedLine Citation:
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PMID: 12595849 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This study was designed to assess whether testing of potential reversibility of pulmonary hypertension (PHT) may be a useful means of defining the short-term prognosis of patients with advanced heart failure and elevated pulmonary artery pressure. In such patients, the reversibility of PHT after acute vasodilator administration is associated with a low early mortality rate after heart transplantation. However, its short-term prognostic value has not yet been determined. METHODS AND RESULTS: Between 1994 and 1998, 76 patients with advanced heart failure and PHT underwent right heart cathetherization. The hemodynamic measurements, including thermodilution-derived right ventricular ejection fraction, were repeated after an intravenous bolus of nitroglycerin (NTG). During a median follow-up period of 8.2 months (25% and 75% centiles, 3.3 and 18.9 months), 47 patients had a cardiac event (death or urgent heart transplantation). With Cox survival analysis, a multivariate model that included the New York Heart Association class and the hemodynamic variables obtained after NTG administration allowed a better assessement of the short-term prognosis of the patients than a model including the baseline variables. The evaluation of right ventricular function during the acute NTG-induced pulmonary vasodilation was of critical importance in obtaining such a refinement in the prognostic stratification. CONCLUSIONS: The prognostic evaluation of patients with advanced heart failure and PHT should include the assessment of the changes of right ventricular ejection fraction after acute afterload reduction. |
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Authors:
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Antonello Gavazzi; Stefano Ghio; Laura Scelsi; Carlo Campana; Catherine Klersy; Alessandra Serio; Claudia Raineri; Luigi Tavazzi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 145 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-02-21 Completed Date: 2003-03-18 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 310-6 Citation Subset: AIM; IM |
Affiliation:
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Dipartimento di Cardiologia, IRCCS Policlinico S Matteo, Pavia, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Analysis of Variance Cardiotonic Agents Female Heart Catheterization / methods Heart Failure / drug therapy*, mortality, physiopathology Heart Transplantation Hemodynamics / drug effects, physiology Humans Hypertension, Pulmonary / drug therapy*, mortality, physiopathology Male Middle Aged Nitroglycerin / therapeutic use* Prognosis Proportional Hazards Models Stroke Volume / drug effects Survival Analysis Vascular Resistance / drug effects, physiology Vasodilator Agents / therapeutic use* Ventricular Dysfunction, Left / complications Ventricular Function, Right / drug effects*, physiology |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents; 0/Vasodilator Agents; 55-63-0/Nitroglycerin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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