Usefulness of Pulmonary Artery Pressure by Echocardiography to Predict Outcome in Patients Receiving Cardiac Resynchronization Therapy Heart Failure

• Published in: The American journal of cardiology 2008-01, Vol.101 (2), p.238-241
• Main Authors: Shalaby, Alaa, MD, Voigt, Andrew, MD, El-Saed, Aiman, MD, PhD, Saba, Samir, MD
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Cardiac Pacing, Artificial; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular system; Echocardiography; Female; Heart; Heart failure; Heart Failure - mortality; Heart Failure - physiopathology; Heart Failure - therapy; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Hypertension; Hypertension, Pulmonary - diagnosis; Hypertension, Pulmonary - mortality; Hypertension, Pulmonary - physiopathology; Investigative techniques, diagnostic techniques (general aspects); Male; Medical Records; Medical sciences; Men; Mortality; Pennsylvania - epidemiology; Predictive Value of Tests; Pulmonary Wedge Pressure; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Retrospective Studies; Survival Analysis; Transplants & implants; Ultrasonic investigative techniques; White people
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2007.07.064

Secondary pulmonary hypertension is a marker of advanced heart failure (HF) that confers a poor prognosis. Consecutive patients from 2004 through 2005 who underwent echocardiographic assessments of systolic pulmonary arterial pressure (SPAP) before the implantation of cardiac resynchronization therapy defibrillators were included. Patients were divided into tertiles according to baseline SPAP. Patients in the lowest (group I, 20 to 29 mm Hg) and highest (group III, 45 to 88 mm Hg) tertiles were compared for the end points or death or transplantation and for HF hospital admission. Two hundred seventy patients were evaluated, of whom 95% were Caucasians and 91% men. The mean age was 66.5 ± 11.6 years, the mean QRS duration was 155 ± 30 ms, the mean left ventricular ejection fraction was 22.6 ± 9.7%, and the mean New York Heart Association functional class was 3.0 ± 0.4. In a multivariate model, death or transplantation was significantly more likely in group III (hazard ratio 2.62, 95% confidence interval 1.1 to 6.4, p = 0.036), as was HF admission (hazard ratio 6.35, 95% confidence interval 2.6 to 15.8, p