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. 2022 Jan 28;30(1):1-7.
doi: 10.5606/tgkdc.dergisi.2022.22254. eCollection 2022 Jan.

Relationship between right atrial pressure and the Model for End-Stage Liver Disease (MELD) score in patients with advanced heart failure

Rezzan Deniz Acar  1 , Şencan Acar  2 , Mustafa Emre Gürcü  3 , Cem Doğan  1 , Zübeyde Bayram  1 , Samet Uysal  1 , Büşra Güvendi  1 , Özgür Yaşar Akbal  1 , Cihangir Kaymaz  1 , Mehmet Kaan Kırali  4 , Nihal Özdemir  1
Affiliations

Relationship between right atrial pressure and the Model for End-Stage Liver Disease (MELD) score in patients with advanced heart failure

Rezzan Deniz Acar et al. Turk Gogus Kalp Damar Cerrahisi Derg. .

Abstract

Background: This study aims to investigate the association between right atrial pressure and the Model for End-Stage Liver Disease score and to evaluate the ability of this scoring system to accurately predict the value of right atrial pressure.

Methods: Between April 2016 and November 2018, a total of 137 patients (118 males, 19 females; median age: 49 years; range, 40 to 54 years) with advanced heart failure who were candidates for left ventricular assist device implantation or heart transplantation were retrospectively analyzed. We developed a formula calculated by using the biochemical and cardiac catheterization parameters of the patients.

Results: There was a strong correlation between the right atrial pressure and the scores (r=0.510, p<0.001). The estimated right atrial pressure was calculated as "2 + (0.92 x Model for End-Stage Liver Disease Score)" (unstandardized coefficient 0.920, t value 7.674, p<0.001). The Model for End-Stage Liver Disease score was found to be an independent predictor of high right atrial pressure (odds ratio=1.491, 95% confidence interval: 1.244-1.786, p<0.001). The calculated area under the curve was 0.789 (95% confidence interval: 0.710-0.867, p<0.001) and the cut-off value of the Model for End-Stage Liver Disease score in the prediction of high right atrial pressure was 10.5 with 75% sensitivity and 73% specificity.

Conclusion: We define a method to calculate right atrial pressure obtained by using the Model for End-Stage Liver Disease score without the need for cardiac catheterization during the hospitalization and follow-up period of patients with advanced heart failure.

Keywords: Advanced heart failure; Model for End-Stage Liver Disease Score; right atrial pressure.

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Conflict of interest statement

Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Figures

Figure 1
Figure 1. The estimated RA pressure was calculated as "2 + (0.92xMELD Score)" (unstandardized coefficient 0.920, t value 7.674 and p<0.001) according to the linear regression analyses.
Figure 2
Figure 2. (a-c) The correlation coefficients between RAP and the parameters that are used in the calculation of the MELD Score such as total bilirubin, INR and creatinine were 0.521 (p<0.001), 0.358 (p<0.001) and 0.251 (p=0.003) respectively.
RAP: Right atrial pressure; INR: International normalized ratio
Figure 3
Figure 3. The calculated AUC was 0.789 (95% CI: 0.710-0.867, p<0.001) and cut- off value of MELD score in prediction of high RAP was 10.5 (sensitivity and specificity was 75% and 73%, respectively).
ROC: Receiver operating characteristic; AUC: Under the curve; CI: Confidence interval; RAP: Right atrial pressure.
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References

    1. Kamath PS, Wiesner RH, Malinchoc M, Kremers W, Therneau TM, Kosberg CL, et al. A model to predict survival in patients with end-stage liver disease. Hepatology. 2001;33:464–470. - PubMed
    1. Costa BP, Sousa FC, Serôdio M, Carvalho C. Value of MELD and MELD-based indices in surgical risk evaluation of cirrhotic patients: Retrospective analysis of 190 cases. World J Surg. 2009;33:1711–1719. - PubMed
    1. Malinchoc M, Kamath PS, Gordon FD, Peine CJ, Rank J, ter Borg PC. A model to predict poor survival in patients undergoing transjugular intrahepatic portosystemic shunts. Hepatology. 2000;31:864–871. - PubMed
    1. Ailawadi G, Lapar DJ, Swenson BR, Siefert SA, Lau C, Kern JA, et al. Model for end-stage liver disease predicts mortality for tricuspid valve surgery. Ann Thorac Surg. 2009;87:1460–1467. - PMC - PubMed
    1. Szyguła-Jurkiewicz B, Nadziakiewicz P, Zakliczynski M, Szczurek W, Chraponski J, Zembala M, et al. Predictive value of hepatic and renal dysfunction based on the models for end-stage liver disease in patients with heart failure evaluated for heart transplant. Transplant Proc. 2016;48:1756–1760. - PubMed

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