학술논문
Left-to-right ventricular volume ratio and outcome in heart failure with preserved ejection fraction.
Document Type
Academic Journal
Author
Aimo A; Scuola Superiore Sant'Anna.; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.; Teis A; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; Kasa G; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; Juncà G; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; Lupón J; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; Domingo M; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; Ferrer E; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; Vallejo N; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; Cediel G; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; Codina P; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; López-Ayerbe J; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; Georgiopoulos G; Scuola Superiore Sant'Anna.; King's College, London, UK.; Cardiology Centre, University of Ferrara, Ferrara.; Martini N; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.; Emdin M; Scuola Superiore Sant'Anna.; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.; Bayes-Genís A; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; CIBERCV, Carlos III Institute of Health, Madrid.; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; Rapezzi C; King's College, London, UK.; Cardiology Centre, University of Ferrara, Ferrara.; Maria Cecilia Hospital, GVM Care & Research, Cotignola (Ravenna), Italy.; Delgado V; Heart Institute, Hospital University Germans Trias i Pujol, Badalona.; Department of Cardiology, Leiden University Medical Center, the Netherlands.
Source
Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 101259752 Publication Model: Print Cited Medium: Internet ISSN: 1558-2035 (Electronic) Linking ISSN: 15582027 NLM ISO Abbreviation: J Cardiovasc Med (Hagerstown) Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Age-specific and gender-specific reference values for left ventricular (LV) and right ventricle volumes are available. The prognostic implications of the ratio between these volumes in heart failure and preserved ejection fraction (HFpEF) have never been evaluated.
Methods: We examined all HFpEF outpatients undergoing a cardiac magnetic resonance from 2011 to 2021. The left-to-right ventricular volume ratio (LRVR) was defined as the ratio between the LV and right ventricle end-diastolic volume indexes (LVEDVi/RVEDVi).
Results: Among 159 patients [median age 58 years (interquartile range 49-69), 64% men, LV ejection fraction 60% (54-70%)] the median LRVR was 1.21 (1.07-1.40). Over 3.5 years (1.5-5.0), 23 patients (15%) experienced all-cause death or heart failure hospitalization, and 22 (14%) cardiovascular death or heart failure hospitalization. The risk of all-cause death or heart failure hospitalization increased with an LRVR less than 1.0 or at least 1.4. An LRVR less than 1.0 was associated with a higher risk of all-cause death or heart failure hospitalization [hazard ratio 5.95, 95% confidence interval (CI) 1.67-21.28; P = 0.006] and cardiovascular death or heart failure hospitalization (hazard ratio 5.68, 95% CI 1.58-20.35; P = 0.008) as compared with LRVR 1.0-1.3. Furthermore, an LRVR at least 1.4 was associated with a higher risk of all-cause death or heart failure hospitalization (hazard ratio 4.10, 95% CI 1.58-10.61; P = 0.004) and cardiovascular death or heart failure hospitalization (hazard ratio 3.71, 95% CI 1.41-9.79; P = 0.008) as compared with LRVR 1.0-1.3. These results were confirmed in patients without dilation of either ventricle.
Conclusion: LRVR values less than 1.0 or at least 1.4 are associated with worse outcomes in HFpEF. LRVR may become a valuable tool for risk prediction in HFpEF.
(Copyright © 2023 Italian Federation of Cardiology - I.F.C. All rights reserved.)
Methods: We examined all HFpEF outpatients undergoing a cardiac magnetic resonance from 2011 to 2021. The left-to-right ventricular volume ratio (LRVR) was defined as the ratio between the LV and right ventricle end-diastolic volume indexes (LVEDVi/RVEDVi).
Results: Among 159 patients [median age 58 years (interquartile range 49-69), 64% men, LV ejection fraction 60% (54-70%)] the median LRVR was 1.21 (1.07-1.40). Over 3.5 years (1.5-5.0), 23 patients (15%) experienced all-cause death or heart failure hospitalization, and 22 (14%) cardiovascular death or heart failure hospitalization. The risk of all-cause death or heart failure hospitalization increased with an LRVR less than 1.0 or at least 1.4. An LRVR less than 1.0 was associated with a higher risk of all-cause death or heart failure hospitalization [hazard ratio 5.95, 95% confidence interval (CI) 1.67-21.28; P = 0.006] and cardiovascular death or heart failure hospitalization (hazard ratio 5.68, 95% CI 1.58-20.35; P = 0.008) as compared with LRVR 1.0-1.3. Furthermore, an LRVR at least 1.4 was associated with a higher risk of all-cause death or heart failure hospitalization (hazard ratio 4.10, 95% CI 1.58-10.61; P = 0.004) and cardiovascular death or heart failure hospitalization (hazard ratio 3.71, 95% CI 1.41-9.79; P = 0.008) as compared with LRVR 1.0-1.3. These results were confirmed in patients without dilation of either ventricle.
Conclusion: LRVR values less than 1.0 or at least 1.4 are associated with worse outcomes in HFpEF. LRVR may become a valuable tool for risk prediction in HFpEF.
(Copyright © 2023 Italian Federation of Cardiology - I.F.C. All rights reserved.)