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. 2022 Jul-Aug;74(4):314-321.
doi: 10.1016/j.ihj.2022.03.002. Epub 2022 Mar 26.

Right ventricular systolic pressure - Non-invasive bedside predictor of mortality and readmission in heart failure with reduced and preserved ejection fraction hospitalization

Monil Majmundar  1 , Tikal Kansara  2 , Ashish Kumar  3 , Hansang Park  2 , Palak Shah  2 , Rajkumar Doshi  4 , Harshvardhan Zala  5 , Hossam Amin  2 , Shobhana Chaudhari  2 , Ankur Kalra  6
Affiliations

Right ventricular systolic pressure - Non-invasive bedside predictor of mortality and readmission in heart failure with reduced and preserved ejection fraction hospitalization

Monil Majmundar et al. Indian Heart J. 2022 Jul-Aug.

Abstract

Objective: To study the prognostic role of right ventricular systolic pressure (RVSP) in patients with heart failure (HF).

Background: Although RVSP is a readily available echocardiographic parameter, it is often underused. Its prognostic role in patients with heart failure is not well established compared with pulmonary artery pressure measured by right heart catheterization.

Methods: This single-center retrospective cohort study included patients with acute heart failure hospitalization admitted to the hospital from January 2005 to December 2018. The primary predictor was right ventricular systolic pressure (RVSP) obtained from bedside transthoracic echocardiography at admission. We divided RVSP into two groups, RVSP <40 mm Hg (reference group) and RVSP ≥40 mm Hg. Primary outcome was all-cause mortality. Secondary outcomes were all-cause readmission and cardiac readmission. We conducted propensity-score matching and applied cox-proportional hazard model to compute hazard ratio (HR) with 95% confidence interval (CI).

Results: Out of 972 HF patients, 534 patients had RVSP <40 mm Hg and 438 patients had RVSP ≥40 mm Hg. Patients with RVSP ≥40 mm Hg compared with RVSP <40 mm Hg were associated with higher rates of death [HR: 1.60, 95% CI: 1.22-2.09, P-value = 0.001], all-cause readmissions [HR: 1.37, 95% CI: 1.09-1.73, P-value = 0.008] and cardiac readmissions [HR: 1.41, 95% CI: 1.07-1.85, P-value = 0.014].

Conclusion: Higher RVSP (≥40 mm Hg) in HF patients was associated with higher rates of death, all-cause readmissions, and cardiac readmissions. RVSP can be considered as a prognostic marker for mortality and readmission.

Keywords: Death; Heart failure; Readmission; Right ventricular systolic pressure.

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Conflict of interest statement

Declaration of competing interest The authors reported no potential conflicts of interest, relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the article.

Figures

Fig. 1
Fig. 1
Kaplan–Meier graph of mortality by Right Ventricular Systolic Pressure.
Fig. 2
Fig. 2
Kaplan–Meier graph of all-cause readmission by Right Ventricular Systolic Pressure.
Fig. 3
Fig. 3
Kaplan–Meier graph of cardiac readmission by Right Ventricular Systolic Pressure.
Fig. 4
Fig. 4
Kaplan–Meier graph of death/readmission by Right Ventricular Systolic Pressure.
See this image and copyright information in PMC

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