Low Aortic Pulsatility Index and Pulmonary Artery Pulsatility Index Are Associated With Increased Mortality in Patients With Dilated Cardiomyopathy Awaiting Heart Transplantation.

IF 3 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Korean Circulation Journal Pub Date : 2024-10-17 DOI:10.4070/kcj.2024.0192
Yihang Wu, Yuhui Zhang, Jian Zhang
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Abstract

Background and objectives: Patients with dilated cardiomyopathy (DCM) tend to be accompanied by biventricular impairment. We hypothesized that the combination of the aortic pulsatility index (API) and pulmonary artery pulsatility index (PAPI) could refine risk stratification in DCM.

Methods: We studied 120 consecutive patients with advanced DCM who underwent right heart catheterization (RHC). The primary outcome was all-cause mortality within 1 year after RHC. We used the receiver operating characteristic curve to determine the optimal cut-off of API and PAPI to predict outcomes.

Results: The optimal cut-offs of API (1.02) and PAPI (2.16) were used to classify patients into four groups. There were significant differences in left ventricular ejection fraction (LVEF) and tricuspid annular plane systolic excursion (TAPSE) among the four groups (both p<0.05). When delineating API by LVEF above or below the median (28%), the cumulative rate of survival in patients with API <1.02 was lower than that of those with API ≥1.02 in both higher and lower LVEF groups (both p<0.05). Similar trends were observed when delineating PAPI using TAPSE higher or lower than the cut-off (17 mm) (both p<0.05). The cumulative rate of survival in the API <1.02 and PAPI <2.16 group was lower than that in the API ≥1.02 and/or PAPI ≥2.16 (all p<0.05).

Conclusions: API and PAPI could add additional prognostic value to LVEF and TAPSE, respectively. The combination of API and PAPI could provide a comprehensive assessment of biventricular function and refine risk stratification.

Trial registration: ClinicalTrials.gov Identifier: NCT02664818.

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低主动脉搏动指数和肺动脉搏动指数与等待心脏移植的扩张型心肌病患者死亡率增加有关。
背景和目的:扩张型心肌病(DCM)患者往往伴有双心室功能损害。我们假设,结合主动脉搏动指数(API)和肺动脉搏动指数(PAPI)可完善 DCM 的风险分层:我们对 120 名接受右心导管检查(RHC)的晚期 DCM 患者进行了连续研究。主要结果是 RHC 术后 1 年内的全因死亡率。我们使用接收者操作特征曲线确定了预测结果的 API 和 PAPI 最佳临界值:结果:API(1.02)和 PAPI(2.16)的最佳临界值将患者分为四组。四组患者的左心室射血分数(LVEF)和三尖瓣环平面收缩期偏移(TAPSE)存在明显差异(均为 pConclusions):API 和 PAPI 可分别为 LVEF 和 TAPSE 增加额外的预后价值。API 和 PAPI 的组合可提供双心室功能的综合评估,并完善风险分层:试验注册:ClinicalTrials.gov Identifier:试验注册:ClinicalTrials.gov Identifier:NCT02664818。
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来源期刊
Korean Circulation Journal
Korean Circulation Journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.90
自引率
17.20%
发文量
103
期刊介绍: Korean Circulation Journal is the official journal of the Korean Society of Cardiology, the Korean Pediatric Heart Society, the Korean Society of Interventional Cardiology, and the Korean Society of Heart Failure. Abbreviated title is ''Korean Circ J''. Korean Circulation Journal, established in 1971, is a professional, peer-reviewed journal covering all aspects of cardiovascular medicine, including original articles of basic research and clinical findings, review articles, editorials, images in cardiovascular medicine, and letters to the editor. Korean Circulation Journal is published monthly in English and publishes scientific and state-of-the-art clinical articles aimed at improving human health in general and contributing to the treatment and prevention of cardiovascular diseases in particular. The journal is published on the official website (https://e-kcj.org). It is indexed in PubMed, PubMed Central, Science Citation Index Expanded (SCIE, Web of Science), Scopus, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, KoreaMed, KoreaMed Synapse and KoMCI, and easily available to wide international researchers
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