Long-term Prognostic Significance of Admission Tricuspid Regurgitation Pressure Gradient in Hospitalized Patients With Heart Failure With Preserved Ejection Fraction: A Report From the Japanese Real-World Multicenter Registry

Omote, Kazunori; Nagai, Toshiyuki; Kamiya, Kiwamu; Aikawa, Tadao; Tsujinaga, Shingo; Kato, Yoshiya; Komoriyama, Hirokazu; Iwano, Hiroyuki; Yamamoto, Kazuhide; Yoshikawa, Tsutomu; Saito, Yoshihiko; Anzai, Toshihisa

doi:10.1016/j.cardfail.2019.07.010

Cited by 13 publications

(9 citation statements)

References 42 publications

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“…A novel finding of the present study is that decrease in TRPG during follow‐up was associated with better outcomes, despite higher TRPG values during hospitalization. Previous reports have shown worsening effect of high TRPG on the prognosis of patients with HF 10–12 . However, in the present study, the decrease in TRPG group had a significantly higher TRPG value and a lower LVEF at ADHF hospitalization, but nevertheless showed favourable outcomes.…”

Section: Discussioncontrasting

confidence: 77%

“…9 Previous reports have shown that elevated TRPG is associated with poor long-term outcome in patients with HF. [10][11][12] We routinely perform a follow-up echocardiography to check cardiac conditions and to assess the effect of therapy. However, no study has investigated the association of the difference in TRGP between hospitalization and 6 month follow-up with subsequent clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

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A decrease in tricuspid regurgitation pressure gradient associates with favorable outcome in patients with heart failure

et al. 2021

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Aims Although the prognostic impact of the high tricuspid regurgitation pressure gradient (TRPG) has been investigated, the association of the decrease in TRPG during follow-up with clinical outcomes in heart failure (HF) has not been previously studied. The aim of this study was to investigate the association of a decrease in TRPG between hospitalization and 6 month visit with subsequent clinical outcomes in patients with acute decompensated HF (ADHF). Methods and results Among 721 patients with available TRPG data both during hospitalization and a subsequent 6 month visit, the study population was divided into two groups: a decrease in TRPG group (>10 mmHg decrease at 6 month visit) (N = 179) and no decrease in TRPG group (N = 542). The primary outcome measure was a composite of all-cause death or HF hospitalization. The cumulative 6 month incidence of primary outcome measure was significantly lower in the decrease in TRPG group than in the no decrease in TRPG group (12.2% vs. 18.7%, P = 0.02). After adjusting for confounders, there was a significantly lower risk in decrease in TRPG group than in the no decrease in TRPG group for the measured primary outcome (hazard ratio: 0.56, 95% confidence interval 0.32-0.93, P = 0.02). The lower risk in decrease in TRPG group was not different among the basal TRPG values. Conclusions Heart failure patients with a decrease in TRPG at 6 months after discharge from ADHF hospitalization had lower subsequent risk of all-cause death and HF hospitalization than those without a decrease in TRPG, regardless of TRPG values.

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Section: Discussioncontrasting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

A decrease in tricuspid regurgitation pressure gradient associates with favorable outcome in patients with heart failure

et al. 2021

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“…The following variables have reported as prognostic markers in the acute phase in HFpEF patients: TRPG [31], lung congestion observed as B-lines ('comets') on lung ultrasound [32], soluble suppression of tumorigenesis-2 with NT-proBNP [33] and cystatin C [34]. In addition to these factors, our findings showed that higher plasma osmolality also has important prognostic implications in the acute phase of HFpEF.…”

Section: What Are the Clinical Implications?supporting

confidence: 57%

Prognostic relevance of elevated plasma osmolality on admission in acute decompensated heart failure with preserved ejection fraction: insights from PURSUIT-HFpEF registry

Nakagawa¹,

Yasumura²,

Yoshida³

et al. 2021

BMC Cardiovasc Disord

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Background Complicated pathophysiology makes it difficult to identify the prognosis of heart failure with preserved ejection fraction (HFpEF). While plasma osmolality has been reported to have prognostic importance, mainly in heart failure with reduced ejection fraction (HFrEF), its prognostic meaning for HFpEF has not been elucidated. Methods We prospectively studied 960 patients in PURSUIT-HFpEF, a multicenter observational study of acute decompensated HFpEF inpatients. We divided patients into three groups according to the quantile values of plasma osmolality on admission. During a follow-up averaging 366 days, we examined the primary composite endpoint of cardiac mortality or heart failure re-admission using Kaplan–Meier curve analysis and Cox proportional hazard testing. Results 216 (22.5%) patients reached the primary endpoint. Kaplan–Meier curve analysis revealed that the highest quantile of plasma osmolality on admission (higher than 300.3 mOsm/kg) was significantly associated with adverse outcomes (Log-rank P = 0.0095). Univariable analysis in the Cox proportional hazard model also revealed significantly higher rates of adverse outcomes in the higher plasma osmolality on admission (hazard ratio [HR] 7.29; 95% confidence interval [CI] 2.25–23.92, P = 0.0009). Multivariable analysis in the Cox proportional hazard model also showed that higher plasma osmolality on admission was significantly associated with adverse outcomes (HR 5.47; 95% CI 1.46–21.56, P = 0.0113) independently from other confounding factors such as age, gender, comorbid of atrial fibrillation, hypertension history, diabetes, anemia, malnutrition, E/e′, and N-terminal pro-B-type natriuretic peptide elevation. Conclusions Higher plasma osmolality on admission was prognostically important for acute decompensated HFpEF inpatients.

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“…However, the exact pathophysiological mechanism of HHD complicated with PH has not been fully understood. It may occur as overlapping consequences of the following several theories: (1) hemodynamic changes [27]: compared with systemic circulation, pulmonary circulation presents a lower compensatory ability for hyperdynamic blood flow. Therefore, when hyperthyroidism occurs, apparent increase in cardiac output would result in PASP elevation [35].…”

Section: Discussionmentioning

confidence: 99%

The Association of Autoantibodies in Hyperthyroid Heart Disease Combined with Pulmonary Hypertension

Zhang

Chen

Sheng³

et al. 2019

International Journal of Endocrinology

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Hyperthyroidism is a clinical state that results from increased thyroid hormone levels which has a significant impact on cardiac function and structure. Graves' disease is the most common cause of hyperthyroidism in iodine-replete areas. Hyperthyroid heart disease may be associated with pulmonary hypertension in patients who have overt hyperthyroidism. To investigate the association of pulmonary hypertension induced by hyperthyroid heart disease and autoantibody, one hundred and one cases with hyperthyroid heart disease who were consecutively admitted to the inpatient department of endocrinology and metabolism of the Shandong Provincial Hospital between November 2014 and April 2018 were collected and analyzed statistically. According to the Independent samples T-test, variance analysis, chi-square test, Pearson linear correlation analysis, and logistic regression, there was a good correlation between pulmonary artery systolic pressure and thyroid stimulating hormone (TSH) and receptor antibodies (TRAb) (r = 0.264, P=0.025) (OR = 1.037, P=0.029), but there was no significant correlation between the pulmonary artery systolic pressure and other thyroid-related parameters (FT3, FT4, TSH, anti-TPO, and anti-TG). Based on variance analysis, PASP rose as the level of TRAb gets higher. What is more, patients with HHD combined with PH showed a significantly higher serum level of TRAb; moreover, serum TRAb concentration was remarkably correlated with the PASP level. Therefore, TRAb participates in the process of pulmonary hypertension caused by hyperthyroid heart disease.

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Long-term Prognostic Significance of Admission Tricuspid Regurgitation Pressure Gradient in Hospitalized Patients With Heart Failure With Preserved Ejection Fraction: A Report From the Japanese Real-World Multicenter Registry

Cited by 13 publications

References 42 publications

A decrease in tricuspid regurgitation pressure gradient associates with favorable outcome in patients with heart failure

A decrease in tricuspid regurgitation pressure gradient associates with favorable outcome in patients with heart failure

Prognostic relevance of elevated plasma osmolality on admission in acute decompensated heart failure with preserved ejection fraction: insights from PURSUIT-HFpEF registry

The Association of Autoantibodies in Hyperthyroid Heart Disease Combined with Pulmonary Hypertension

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