Accuracy of systolic aortic regurgitation in the diagnosis of heart failure: a predictive approach

Saura, Daniel; Oliva, María J.; Caballero, Luis; González-Carrillo, Josefa; Espinosa, María Dolores; López-Ruiz, María; García-Navarro, Miguel; Morena, Gonzalo de la

doi:10.1111/ijcp.12566

Cited by 2 publications

(7 citation statements)

References 20 publications

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“…Like systolic AR, physicians are acquired to focus more on systolic PR. 1 , 2 , 3 , 4 , 5 , 6 , 7 Before elucidating systolic PR, systolic AR might provide some clues. Based on data, the prevalence of systolic AR is higher in HF population (5.9% vs. 2.1%).…”

Section: Discussionmentioning

confidence: 99%

“…Systolic AR had been identified in valvular heart disease or heart failure (HF) and showed capability for predicting HF. 1 , 2 , 3 , 4 , 5 , 6 Systolic AR was explained as the inability of the ventricular contraction to overcome the aortic pressure in patients with valvular incompetence. This phenomenon is associated with pulsus alternans and ineffective contraction, which is common in severe left‐side HF.…”

Section: Introductionmentioning

confidence: 99%

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Systolic pulmonary regurgitation affects the outcome of patients with severe systolic heart failure

Hsiao

Chiou

2021

ESC Heart Failure

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Aims Little is known of the impact of systolic pulmonary regurgitation (PR) on acute decompensated heart failure (HF). We assessed the prevalence and prognostic significance of systolic PR in patients with severe HF. Methods and results According to recent 10 year echocardiographic database of E‐Da Hospital, 533 patients admitted for first systolic heart failure (HF) and left ventricular ejection fraction <35% were under investigation. Systolic PR was defined as the presence of pulmonary backward flow persistent after QRS in electrocardiogram. Isovolumic contraction/relaxation time and myocardial performance index were derived by tissue Doppler imaging. Right ventricular (RV) function was assessed by RV fractional area change. Estimated pulmonary vascular resistance (PVR) was assessed by the ratio of peak tricuspid regurgitation velocity to the RV outflow tract time–velocity integral. The factors associated with systolic PR were assessed by multivariate logistic regression. Cox proportional regression analyses were used to estimate the impact of cardiovascular events including HF rehospitalization and cardiovascular death. For estimated prevalence of 5480 control subjects, echocardiographic screens in those with normal left ventricular ejection fraction were performed. Of 533 systolic HF cases, 143 (26.8%) had systolic PR during indexed hospitalization. Among 143 cases, 86% systolic PR disappeared during late follow‐up. In control subjects, 0.3% (18/5480) had systolic PR. Systolic PR correlated to RV dysfunction, estimated PVR, E/e′, sign of low cardiac output, and pulmonary oedema. Systolic PR was associated independently with further cardiovascular events (hazard ratio 2.266, 95% confidence interval 1.682–3.089, P < 0.0001) including cardiovascular death and HF rehospitalization. Conclusions Systolic PR is not uncommon in systolic HF and is associated with high PVR and RV dysfunction. Systolic PR significantly impacts cardiovascular outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Systolic pulmonary regurgitation affects the outcome of patients with severe systolic heart failure

Hsiao

Chiou

2021

ESC Heart Failure

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“…The SAR was detected in 2.3% of all investigations and it was detected in 5.9% of the patients with HF [ 11 ]. In another study, patients with dyspnea were included [ 16 ]. SAR was present in 3.3% of the patients, and the prevalence of HF was 40.3% [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…In another study, patients with dyspnea were included [ 16 ]. SAR was present in 3.3% of the patients, and the prevalence of HF was 40.3% [ 16 ]. The authors found that the specificity of SAR was 99.4% for the HF diagnosis [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Systolic aortic regurgitation predicts all-cause mortality and hospitalization in outpatients with heart failure and preserved ejection fraction

Bolat¹

2020

North Clin Istanbul

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Cite this article as: Bolat I, Biteker M. Systolic aortic regurgitation predicts all-cause mortality and hospitalization in outpatients with heart failure and preserved ejection fraction. North Clin Istanb ABSTRACT OBJECTIVE: Systolic aortic regurgitation (SAR) is considered to be a specific sign of heart failure (HF). However, the prevalence and importance of SAR in patients with HF and preserved ejection fraction (HFpEF) is unknown. Therefore, we sought to examine the prevalence of SAR in HFpEF outpatients, and its association with all-cause mortality and/or cardiovascular hospitalizations during 1-year follow-up. METHODS:We enrolled 301 consecutive outpatients with HFpEF (mean age of 67.3±9.6 years, 53.5% women) and prospectively followed up for 1 year. Demographic, clinical, echocardiographic, and laboratory data were obtained at study entry. The composite endpoint of the study was all-cause mortality or HF-related hospitalizations at one year. RESULTS: SAR was noted in 30 (9.9%) of the patients, and 38 patients (12.6%) reached the primary endpoint. The primary composite endpoint at 1 year was greater for patients with SAR (26.3%) compared to those without SAR (7.6%, p<0.001). After adjusting for important covariates, SAR remained independently associated with primary outcome (OR 2.315; 95% CI 1.188-5.477; p=0.008). CONCLUSION:This is the first study to demonstrate that the presence of SAR is associated with adverse events in HFpEF patients.

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Accuracy of systolic aortic regurgitation in the diagnosis of heart failure: a predictive approach

Abstract: In patients admitted to hospital with dyspnea, the finding of systolic aortic regurgitation in echocardiography has a high PPV for HF diagnosis at discharge.

Cited by 2 publications

References 20 publications

Systolic pulmonary regurgitation affects the outcome of patients with severe systolic heart failure

Systolic pulmonary regurgitation affects the outcome of patients with severe systolic heart failure

Systolic aortic regurgitation predicts all-cause mortality and hospitalization in outpatients with heart failure and preserved ejection fraction

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