This article is more than 5 years old. Information may no longer be current.

LV end-diastolic pressure significant marker for outcomes after heart catheterization

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

PHILADELPHIA — Following left heart catheterization, offloading measured by left ventricular end-diastolic pressure was a notable marker for worse HF hospitalization-free survival over time.

According to findings presented at the Heart Failure Society of America Scientific Meeting, researchers analyzed 31 patients who underwent catheterization optimization and found that left ventricular end-diastolic pressure (LVEDP) was significantly associated with hospitalization or death and overall survival (HR = 1.2 per 1 mm Hg increase; 95% CI, 1.1-1.3; P < .01)

“On average, we saw improvement over the course of the observation in all hemodynamics; right atrial pressure, pulmonary artery pressure, pulmonary capillary wedge pressure and LVEDP,” Andrew Rosenbaum, MD, cardiologist at Mayo Clinic, said in his presentation. “In the analysis, the only one that predicted 1-year outcomes was LVEDP. Because this was the only variable associated with outcomes, we adjusted for all the clinical parameters, including left ventricular assist device speed, transaortic gradient and cardiac index. This remained a significant predictor of outcome in a multivariate analysis.”

Additionally, following the inclusion of LV assist device speed, transaortic gradient as well as cardiac index in a multivariate model, researchers found that LVEDP remained significantly associated with the primary endpoints (HR = 1.4 per 1 mm Hg; 95% CI, 1.2-1.4; P < .001)

All patients (mean age, 58 years; 40% women; mean BMI, 29 kg/m²) were supported by an LVAD and underwent heart catheterization at Mayo Clinic between 2015 and 2018. Using physiological indices that included LVEDP and transaortic gradient, researchers evaluated the prognostic efficacy of these markers.

The catheterization optimization protocol enabled patients to return to normal hemodynamic parameters, including averages of LVEDP 12 mm Hg and cardiac index 2.53 L/min/m² (P .05 for all), according to the researchers. – by Scott Buzby

Reference:

Rosenbaum A, et al. Abstract 024. Presented at: Heart Failure Society of America Scientific Meeting; Sept. 13-16, 2019; Philadelphia.

Disclosure: Rosenbaum reports no relevant financial disclosures.