Impact of right ventricular stroke work index on predicting hospital readmission and functional status of patients with advanced heart failure

Özenç, Ebru; Yıldız, Ömer; Baydar, Onur; Yazicioğlu, Nuran; Koç, Nurcan Arat

doi:10.1016/j.repc.2020.06.014

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…The increase in FCW intensity was related to an increase in stroke volume from increased inotropy; which explains the increase in indexed RVSW. Indexed RVSW has been shown to be related to adverse outcomes in patients with advanced heart failure 30,31 and right heart failure following LV assist device implantation. 32 16 This implies that the FCW intensity generated from WIA may also be a surrogate of RV performance.…”

Section: Discussionmentioning

confidence: 99%

“…The increase in FCW intensity was related to an increase in stroke volume from increased inotropy; which explains the increase in indexed RVSW. Indexed RVSW has been shown to be related to adverse outcomes in patients with advanced heart failure 30 , 31 and right heart failure following LV assist device implantation. 32 RVSW is a surrogate marker for right ventricular workload taking into account RV contractility and the stroke volume generated, which may explain our observed relationship between RVSW and FCW intensity.…”

Section: Discussionmentioning

confidence: 99%

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Pulmonary artery wave intensity analysis in pulmonary hypertension associated with heart failure and reduced left ventricular ejection fraction

Yim,

Parker,

Drury

et al. 2024

Pulm. circ.

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Wave intensity analysis (WIA) uses simultaneous changes in pressure and flow velocity to determine wave energy, type, and timing of traveling waves in the circulation. In this study, we characterized wave propagation in the pulmonary artery in patients with pulmonary hypertension associated with left‐sided heart disease (PHLHD) and the effects of dobutamine. During right heart catheterization, pressure and velocity data were acquired using a dual‐tipped pressure and Doppler flow sensor wire (Combowire; Phillips Volcano), and processed offline using customized Matlab software (MathWorks). Patients with low cardiac output underwent dobutamine challenge. Twenty patients with PHLHD (all heart failure with reduced left ventricular ejection fraction) were studied. Right ventricular systole produced a forward compression wave (FCW), followed by a forward decompression wave (FDW) during diastole. Wave reflection manifesting as backward compression wave (BCW) following the FCW was observed in 14 patients. Compared to patients without BCW, patients with BCW had higher mean pulmonary artery pressure (28.7 ± 6.12 vs. 38.6 ± 6.5 mmHg, p = 0.005), and lower pulmonary arterial capacitance (PAC: 2.88 ± 1.75 vs. 1.73 ± 1.16, p = 0.002). Pulmonary vascular resistance was comparable. Mean pulmonary artery pressure of 34.5 mmHg (area under the curve [AUC]: 0.881) and PAC of 2.29 mL/mmHg (AUC: 0.833) predicted BCW. The magnitude of the FCW increased with dobutamine (n = 11) and correlated with pulmonary artery wedge pressure. Wave reflection in PHLHD is more likely at higher pulmonary artery pressures and lower PAC and the magnitude of reflected waves correlated with pulmonary artery wedge pressure. Dobutamine increased FCW but did not affect wave reflection.

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Section: Discussionmentioning

confidence: 99%

“…The increase in FCW intensity was related to an increase in stroke volume from increased inotropy; which explains the increase in indexed RVSW. Indexed RVSW has been shown to be related to adverse outcomes in patients with advanced heart failure 30 , 31 and right heart failure following LV assist device implantation. 32 RVSW is a surrogate marker for right ventricular workload taking into account RV contractility and the stroke volume generated, which may explain our observed relationship between RVSW and FCW intensity.…”

Section: Discussionmentioning

confidence: 99%