Right Ventricular Systolic Pressure - Non-Invasive Bedside Predictor of Mortality and Readmission in Heart Failure With Reduced and Preserved Ejection Fraction Hospitalization

Authors

Monil Majmundar, Department of Cardiology, Maimonides Medical Center, Brooklyn, NY, USA; Section of Cardiovascular Research, Heart, Vascular, and Thoracic Department, Cleveland Clinic Akron General, Akron, OH, USA.
Tikal Kansara, Department of Internal Medicine, New York Medical College/Metropolitan Hospital, NY, USA.
Ashish Kumar, Section of Cardiovascular Research, Heart, Vascular, and Thoracic Department, Cleveland Clinic Akron General, Akron, OH, USA; Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA.Follow
Hansang Park, Department of Internal Medicine, New York Medical College/Metropolitan Hospital, NY, USA.
Palak Shah, Department of Internal Medicine, New York Medical College/Metropolitan Hospital, NY, USA.
Rajkumar Doshi, Department of Cardiology, St. Joseph's Medical Center, Paterson, NJ, USA.
Harshvardhan Zala, Department of Clinical Research, Icahn School of Medicine, Mount Sinai Hospital, NYC, NY, USA.
Hossam Amin, Department of Internal Medicine, New York Medical College/Metropolitan Hospital, NY, USA.Follow
Shobhana Chaudhari, Department of Internal Medicine, New York Medical College/Metropolitan Hospital, NY, USA.Follow
Ankur Kalra, Section of Cardiovascular Research, Heart, Vascular, and Thoracic Department, Cleveland Clinic Akron General, Akron, OH, USA; Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: kalramd.ankur@gmail.com.

Author Type(s)

Faculty, Resident/Fellow

DOI

10.1016/j.ihj.2022.03.002

Journal Title

Indian Heart Journal

First Page

314

Last Page

321

Document Type

Article

Publication Date

1-1-2022

Department

Medicine

Abstract

OBJECTIVE: To study the prognostic role of right ventricular systolic pressure (RVSP) in patients with heart failure (HF). BACKGROUND: Although RVSP is a readily available echocardiographic parameter, it is often underused. Its prognostic role in patients with heart failure is not well established compared with pulmonary artery pressure measured by right heart catheterization. METHODS: This single-center retrospective cohort study included patients with acute heart failure hospitalization admitted to the hospital from January 2005 to December 2018. The primary predictor was right ventricular systolic pressure (RVSP) obtained from bedside transthoracic echocardiography at admission. We divided RVSP into two groups, RVSP <40 mm Hg (reference group) and RVSP ≥40 mm Hg. Primary outcome was all-cause mortality. Secondary outcomes were all-cause readmission and cardiac readmission. We conducted propensity-score matching and applied cox-proportional hazard model to compute hazard ratio (HR) with 95% confidence interval (CI). RESULTS: Out of 972 HF patients, 534 patients had RVSP <40 mm Hg and 438 patients had RVSP ≥40 mm Hg. Patients with RVSP ≥40 mm Hg compared with RVSP <40 mm Hg were associated with higher rates of death [HR: 1.60, 95% CI: 1.22-2.09, P-value = 0.001], all-cause readmissions [HR: 1.37, 95% CI: 1.09-1.73, P-value = 0.008] and cardiac readmissions [HR: 1.41, 95% CI: 1.07-1.85, P-value = 0.014]. CONCLUSION: Higher RVSP (≥40 mm Hg) in HF patients was associated with higher rates of death, all-cause readmissions, and cardiac readmissions. RVSP can be considered as a prognostic marker for mortality and readmission.

Recommended Citation

Majmundar, M., Kansara, T., Kumar, A., Park, H., Shah, P., Doshi, R., Zala, H., Amin, H., Chaudhari, S., & Kalra, A. (2022). Right Ventricular Systolic Pressure - Non-Invasive Bedside Predictor of Mortality and Readmission in Heart Failure With Reduced and Preserved Ejection Fraction Hospitalization. Indian Heart Journal, 74 (4), 314-321. https://doi.org/10.1016/j.ihj.2022.03.002