Prognostic Significance of Hemodynamics in Patients With Transposition of the Great Arteries and Systemic Right Ventricle

被引：0

作者：

Aldweib, Nael ^{[1
]}

Deghani, Payam ^{[2
]}

Broberg, Craig S. ^{[1
]}

van Dissel, Alexandra ^{[4
]}

Altibi, Ahmad ^{[1
]}

Wong, Joshua ^{[7
]}

Baker, David ^{[8
]}

Gindi, Salil ^{[10
]}

Khairy, Paul ^{[11
]}

Opotowsky, Alexander R. ^{[3
]}

Shah, Sangeeta ^{[9
]}

Magalski, Anthony ^{[12
,13
]}

Cramer, Jonathan ^{[14
,15
]}

Kauling, Robert M. ^{[16
]}

Dellborg, Mikael ^{[17
]}

Krieger, Eric V. ^{[18
,19
]}

Yeung, Elizabeth ^{[20
]}

Roos-Hesselink, Jolien ^{[16
]}

Aboulhosn, Jamil ^{[21
]}

Nicolarsen, Jeremy ^{[22
]}

Masha, Luke ^{[1
]}

Gallego, Pastora ^{[23
]}

Celermajer, David S. ^{[24
,25
]}

Kay, Joseph ^{[20
]}

Vonder Muhll, Isabelle ^{[26
]}

Jameson, Susan M. ^{[27
,28
]}

O'Donnell, Clare ^{[29
]}

Fusco, Flavia ^{[30
]}

John, Anitha S. ^{[31
]}

Macon, Conrad ^{[1
]}

Antonova, Petra ^{[32
]}

Cotts, Timothy ^{[33
]}

Sarubbi, Berardo ^{[30
]}

Rodriguez III, Fred ^{[34
]}

Dezorzi, Christopher ^{[5
,6
]}

Jayadeva, Pavithra S. ^{[7
]}

Kuo, Marissa ^{[9
]}

Kutty, Shelby ^{[36
]}

Gupta, Tripti ^{[9
]}

Burchill, Luke J. ^{[7
]}

Monserrate, Carla P. Rodriguez ^{[5
,6
]}

Lubert, Adam M. ^{[3
]}

Grewal, Jasmine ^{[35
]}

Pylypchuk, Stephen ^{[26
]}

Belkin, Mark N. ^{[37
]}

Wilson, William M. ^{[7
]}

机构：

[1] Oregon Hlth & Sci Univ, Knight Cardiovasc Inst, Portland, OR 97201 USA

[2] Regina Gen Hosp, Regina, SK, Canada

[3] Univ Cincinnati, Cincinnati Childrens Hosp Med Ctr, Heart Inst, Coll Med,Dept Pediat, Cincinnati, OH USA

[4] Univ Amsterdam, Med Ctr, Amsterdam, Netherlands

[5] Harvard Med Sch, Boston Childrens Hosp, Dept Pediat, Boston, MA USA

[6] Harvard Med Sch, Brigham & Womens Hosp, Dept Med, Div Cardiol, Boston, MA USA

[7] Royal Melbourne Hosp, Dept Med, Melbourne, Vic, Australia

[8] Royal Prince Alfred Hosp, Sydney, NSW, Australia

[9] Ochsner Med Ctr, New Orleans, LA USA

[10] Childrens Hosp Wisconsin, Milwaukee, WI USA

[11] Montreal Heart Inst, Montreal, PQ, Canada

[12] Univ Missouri Kansas City, Kansas City, MO USA

[13] St Lukes Hosp, Chesterfield, MO USA

[14] Childrens Hosp, Omaha, NE USA

[15] Univ Nebraska Med Ctr, Omaha, NE USA

[16] Erasmus MC, Rotterdam, Netherlands

[17] Univ Gothenburg, Sahlgrenska Acad, Inst Med, Gothenburg, Sweden

[18] Univ Washington, Med Ctr, Seattle, WA USA

[19] Seattle Childrens Hosp, Seattle, WA USA

[20] Colorado Univ, Sch Med, Denver, CO USA

[21] Univ Calif Los Angeles, Med Ctr, Los Angeles, CA USA

[22] Providence Spokane, Spokane, WA USA

[23] Hosp Univ Virgen Del Rocio, Seville, Spain

[24] Univ Sydney, Sydney, NSW, Australia

[25] Royal Prince Alfred Hosp, Sydney, NSW, Australia

[26] Univ Alberta, Edmonton, AB, Canada

[27] Stanford Univ, Sch Med, Dept Pediat, Palo Alto, CA USA

[28] Stanford Univ, Sch Med, Dept Med, Palo Alto, CA USA

[29] Auckland City Hosp, Green Lane Paediat & Congenital Cardiac Serv, Auckland, New Zealand

[30] Monaldi Hosp, Naples, Italy

[31] Childrens Natl Hosp, Washington, DC USA

[32] Univ Hosp Motol, Prague, Czech Republic

[33] Univ Michigan, Med Ctr, Ann Arbor, MI USA

[34] Emory Univ Hosp, Atlanta, GA USA

[35] Univ British Columbia, St Pauls Hosp, Div Cardiol, Vancouver, BC, Canada

[36] Johns Hopkins Univ, Baltimore, MD USA

[37] Univ Chicago, Chicago, IL USA

来源：

CIRCULATION-HEART FAILURE | 2024年 / 17卷 / 09期

基金：

美国国家卫生研究院;

关键词：

arterial pressure; cardiac catheterization; cardiac output; congenitally corrected transposition of the great arteries; heart ventricles; hemodynamics; pulmonary wedge pressure; stroke volume; ACUTE MYOCARDIAL-INFARCTION; AFFAIRS CLINICAL-ASSESSMENT; CARDIAC-OUTPUT; HEART-FAILURE; PULMONARY-HYPERTENSION; OXYGEN-CONSUMPTION; MEDICAL THERAPY; PULSE PRESSURE; MORTALITY; THERMODILUTION;

D O I：

10.1161/CIRCHEARTFAILURE.124.011882

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND:Patients with transposition of the great arteries (TGA) and systemic right ventricle often confront significant adverse cardiac events. The prognostic significance of invasive hemodynamic parameters in this context remains uncertain. Our hypothesis is that the aortic pulsatility index and hemodynamic profiling utilizing invasive measures provide prognostic insights for patients with TGA and a systemic right ventricle. METHODS:This retrospective multicenter cohort study encompasses adults with TGA and a systemic right ventricle who underwent cardiac catheterization. Data collection, spanning from 1994 to 2020, encompasses clinical and hemodynamic parameters, including measured and calculated values such as pulmonary capillary wedge pressure, aortic pulsatility index, and cardiac index. Pulmonary capillary wedge pressure and cardiac index values were used to establish 4 distinct hemodynamic profiles. A pulmonary capillary wedge pressure of >= 15 mm Hg indicated congestion, termed wet, while a cardiac index <2.2 L/min per m2 signified inadequate perfusion, labeled cold. The primary outcome comprised a composite of all-cause death, heart transplantation, or the requirement for mechanical circulatory support. RESULTS:Of 1721 patients with TGA, 242 individuals with available invasive hemodynamic data were included. The median follow-up duration after cardiac catheterization was 11.4 (interquartile range, 7.5-15.9) years, with a mean age of 38.5 +/- 10.8 years at the time of cardiac catheterization. Among hemodynamic parameters, an aortic pulsatility index <1.5 emerged as a robust predictor of the primary outcome, with adjusted hazard ratios of 5.90 (95% CI, 3.01-11.62; P<0.001). Among the identified 4 hemodynamic profiles, the cold/wet profile was associated with the highest risk for the primary outcome, with an adjusted hazard ratio of 3.83 (95% CI, 1.63-9.02; P<0.001). CONCLUSIONS:A low aortic pulsatility index (<1.5) and the cold/wet hemodynamic profile are linked with an elevated risk of adverse long-term cardiac outcomes in patients with TGA and systemic right ventricle.

引用

页数：13

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