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- Title
Significance and prognostic impact of v wave on pulmonary artery pressure in patients with heart failure: beyond the wedge pressure.
- Authors
Iwano, Hiroyuki; Yokoyama, Shinobu; Kamiya, Kiwamu; Nagai, Toshiyuki; Tsujinaga, Shingo; Sarashina, Miwa; Ishizaka, Suguru; Chiba, Yasuyuki; Nakabachi, Masahiro; Nishino, Hisao; Murayama, Michito; Okada, Kazunori; Kaga, Sanae; Anzai, Toshihisa
- Abstract
Background: A v wave on pulmonary artery wedge (PAW) pressure sometimes augments and appears on pulmonary artery (PA) pressure wave in patients with heart failure (HF). However, the significance of PA v wave in HF remains to be elucidated. Methods: We retrospectively analyzed pressure waveforms in 61 HF patients (left ventricular ejection fraction 35 ± 15%). On the PAW and PA pressure waveforms, mean pressure as well as peak and amplitude of v waves (ampPAWv and ampPAv, respectively) were measured. Occurrence of worsening HF and cardiac death was recorded for 2 years after the catheterization. Results: The ampPAWv did not correlate with ampPAv. When the patients were divided into 4 groups: I (high-ampPAWv/high-ampPAv), II (high-ampPAWv/low-ampPAv), III (low-ampPAWv/high-ampPAv), and IV (low-ampPAWv/low-ampPAv), the prevalence of group III was low (I: 13, II: 17, III: 4, IV: 27). Mean pressures of PAW and PA were similarly elevated in groups I and II. Cardiac index was lowest (I: 2.0 ± 0.4, II: 2.8 ± 0.6, III: 2.2 ± 0.2, IV: 2.4 ± 0.6 L/min/m2, ANOVA P < 0.01, P < 0.01 for I vs II) and tricuspid annular plane systolic excursion / systolic PA pressure was impaired (I: 0.27 ± 0.07, II: 0.48 ± 0.22, III: 0.59 ± 0.35, IV: 0.68 ± 0.35 mm/mmHg, ANOVA P < 0.01) in group I. During the follow-up, 13 events were observed. Kaplan–Meier analysis showed that patients in group I were at highest risk of cardiac events. Conclusions: PA v was observed mainly in patients with augmented PAW v wave and decreased cardiac index, suggesting an advanced stage of HF. Moreover, augmented PAv was associated with worse outcome in HF patients.
- Subjects
PULMONARY artery; HEART failure patients; SYSTOLIC blood pressure; VENTRICULAR ejection fraction; PULMONARY artery catheters
- Publication
Heart & Vessels, 2020, Vol 35, Issue 8, p1079
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-020-01580-6