Paper
Prognostic Value of Wave Intensity in Patients Awaiting Heart Transplantation
- Authors:
- Roland Hetzer; Hussein Shwan; Dagmar Kemper; Axel Unbehaun; Michael Dandel; Hans Lehmkuhl; Henryk Siniawski; Julia Stein
- Abstract
- Background: Invasive echocardiographic and wave intensity (WI) parameters were used to predict the clinical outcome of patients on the waiting list for heart transplantation. Methods and results: The study group consisted of 151 consecutive outpatients (age 48.7±12 years; 110 men) with end-stage dilative cardiomyopathy. The patients were divided into Subgroup A (good outcome) and Subgroup B (those suffering death, implantation of mechanical circulatory support or treated by Tx because of worsening). There were no demographic or somatic (weight and height) differences between the two groups. The follow-up period was 31±8 months. Non-invasive WI was studied in the common carotid artery. During follow-up 44 pts were lost; there were 15 cardiac deaths (10%), life-saving ventricular assist device implantation in 10 (6.6%) and transplantation in 19 (12.7%). For statistical purposes a cut-off value was set for “low first peak” (assessed in a previous study as < 4100 mmHg*s³); the cut-off for other echocardiographic and invasive parameters was set on the basis of our own experience. Univariate logistic regression analysis revealed that the most powerful predictor of poor outcome was 1st peak of WI (OR 4.4, CI 2.7-9.5, p<0.001). Less powerful predictors of the risk of deterioration were PCP, diastolic PAP and E/A mitral wave relation (p=0.05). Conclusions: The wave intensity hemodynamic index 1st peak of ventricular-arterial coupling can be used in addition to classical echocardiographic parameters for investigation of patients suffering from heart failure to assess the stage of the disease more precisely than conventional markers of heart function.
- Keywords
- Wave Intensity; Heart Failure; Heart Transplantation
- StartPage
- 95
- EndPage
- 103
- Doi
- 10.5963/JBAP0202008