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