BACKGROUND: The role of the right ventricle has been relatively neglected proportionate to its importance. We sought to evaluate the impact of right ventricular (RV) and NT-proBNP on the outcome of patients with heart failure (HF) and functional mitral regurgitation (MR). METHODS AND PATIENTS: Outpatients with left ventricular (LV) systolic HF (ejection fraction [EF] < or =45%) and moderate-to-severe MR measured by a vena contracta width > or =0.5 cm were prospectively enrolled (n=142). Indexes of LV and RV function, including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change and tissue Doppler RV acceleration at isovolumic contraction and NT-proBNP plasma levels were measured at the time of the index echocardiogram. RESULTS: Multivariate predictors of all-cause mortality included TAPSE<16 mm (hazards ratio [HR]: 2.64; p=0.009) and plasma NT-proBNP> or =3283 pg/ml (HR: 2.58; p=0.011). TAPSE<16 mm and plasma NT-proBNP> or =3283 pg/ml added incremental prognostic information to LV EF< or =25%, NYHA classes 3-4, coronary artery disease, elderly age and male sex. The 36-month Kaplan-Meier curve showed that survival was worst in the group with TAPSE<16 mm and NT-proBNP> or =3283 pg/ml (p<0.0001). CONCLUSION: This study demonstrates the significance of TAPSE and plasma NT-proBNP in predicting all-cause mortality in patients with systolic HF and moderate-to-severe functional MR.
BACKGROUND: The role of the right ventricle has been relatively neglected proportionate to its importance. We sought to evaluate the impact of right ventricular (RV) and NT-proBNP on the outcome of patients with heart failure (HF) and functional mitral regurgitation (MR). METHODS AND PATIENTS: Outpatients with left ventricular (LV) systolic HF (ejection fraction [EF] < or =45%) and moderate-to-severe MR measured by a vena contracta width > or =0.5 cm were prospectively enrolled (n=142). Indexes of LV and RV function, including tricuspid annular plane systolic excursion (TAPSE), RV fractional area change and tissue Doppler RV acceleration at isovolumic contraction and NT-proBNP plasma levels were measured at the time of the index echocardiogram. RESULTS: Multivariate predictors of all-cause mortality included TAPSE<16 mm (hazards ratio [HR]: 2.64; p=0.009) and plasma NT-proBNP> or =3283 pg/ml (HR: 2.58; p=0.011). TAPSE<16 mm and plasma NT-proBNP> or =3283 pg/ml added incremental prognostic information to LV EF< or =25%, NYHA classes 3-4, coronary artery disease, elderly age and male sex. The 36-month Kaplan-Meier curve showed that survival was worst in the group with TAPSE<16 mm and NT-proBNP> or =3283 pg/ml (p<0.0001). CONCLUSION: This study demonstrates the significance of TAPSE and plasma NT-proBNP in predicting all-cause mortality in patients with systolic HF and moderate-to-severe functional MR.
Authors: Andrew C Don-Wauchope; Pasqualina L Santaguida; Mark Oremus; Robert McKelvie; Usman Ali; Judy A Brown; Amy Bustamam; Nazmul Sohel; Stephen A Hill; Ronald A Booth; Cynthia Balion; Parminder Raina Journal: Heart Fail Rev Date: 2014-08 Impact factor: 4.214
Authors: Vien T Truong; Tam N M Ngo; Jan Mazur; Hoai T M Nguyen; Thuy T M Pham; Cassady Palmer; Khanh N P Pham; Hoang T Phan; Kwan S Lee; Marwin Bannehr; Christian Butter; Takayuki Gyoten; Eugene S Chung Journal: ESC Heart Fail Date: 2021-09-22
Authors: Alberto Giannoni; Resham Baruah; Tora Leong; Michaela B Rehman; Luigi Emilio Pastormerlo; Frank E Harrell; Andrew J S Coats; Darrel P Francis Journal: PLoS One Date: 2014-01-27 Impact factor: 3.240