Systemic vasoconstriction and mortality in patients with heart failure and reduced ejection fraction: A cohort of patients who underwent non-invasive hemodynamic monitoring.

Advanced heart failure primarily manifests during and after hospitalization for decompensation. Identifying prognostic factors is crucial for distinguishing patients who may benefit from drug therapy from those with end-stage disease. This study aimed to evaluate the prognostic significance of syste...

Full description

Saved in:
Bibliographic Details
Main Authors: Marcelo Eidi Ochiai, Kelly Regina Vieira Novaes, Lucas Hideki Kato Myakava, Marcelo Villaça Lima, Euler Cristovan Ochiai Brancalhão, Juliano Novaes Cardoso, Solange de Sousa Andrade, Wilson Jacob Filho, Antonio Carlos Pereira Barretto
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2024-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0312582
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1841555472905142272
author Marcelo Eidi Ochiai
Kelly Regina Vieira Novaes
Lucas Hideki Kato Myakava
Marcelo Villaça Lima
Euler Cristovan Ochiai Brancalhão
Juliano Novaes Cardoso
Solange de Sousa Andrade
Wilson Jacob Filho
Antonio Carlos Pereira Barretto
author_facet Marcelo Eidi Ochiai
Kelly Regina Vieira Novaes
Lucas Hideki Kato Myakava
Marcelo Villaça Lima
Euler Cristovan Ochiai Brancalhão
Juliano Novaes Cardoso
Solange de Sousa Andrade
Wilson Jacob Filho
Antonio Carlos Pereira Barretto
author_sort Marcelo Eidi Ochiai
collection DOAJ
description Advanced heart failure primarily manifests during and after hospitalization for decompensation. Identifying prognostic factors is crucial for distinguishing patients who may benefit from drug therapy from those with end-stage disease. This study aimed to evaluate the prognostic significance of systemic vasoconstriction in patients with decompensated heart failure with a reduced ejection fraction. We evaluated patients hospitalized for decompensated heart failure with a left ventricular ejection fraction of < 40% who underwent non-invasive hemodynamic monitoring using the Modelflow method. The primary endpoint was all-cause mortality, and the data were analyzed using logistic regression. This study included 58 patients (71% men) with a mean age of 58.9 years, an ejection fraction of 23.4%, a median B-type natriuretic peptide of 1,005.0 pg/mL (interquartile range = 1,498.0), and 43% with Chagas disease. The cardiac index was 2.7 L∙min-1∙m-2, and the systemic vascular resistance index was 2,403.9 dyn∙s∙cm-5∙m-2. Over an average follow-up of 29.0 months, 51 (87.9%) patients died. Assessing three-year mortality, high systemic vascular resistance indices were predictive of events with a relative risk of 3.9 (95% confidence interval = 1.1-13.9; P-value = 0.037). In conclusion, non-invasive hemodynamic monitoring identifies systemic vasoconstriction, which is associated with poor prognosis in patients with advanced heart failure and reduced ejection fraction.
format Article
id doaj-art-8e59dd5553f64135b5b5cac325c6100d
institution Kabale University
issn 1932-6203
language English
publishDate 2024-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-8e59dd5553f64135b5b5cac325c6100d2025-01-08T05:32:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-011912e031258210.1371/journal.pone.0312582Systemic vasoconstriction and mortality in patients with heart failure and reduced ejection fraction: A cohort of patients who underwent non-invasive hemodynamic monitoring.Marcelo Eidi OchiaiKelly Regina Vieira NovaesLucas Hideki Kato MyakavaMarcelo Villaça LimaEuler Cristovan Ochiai BrancalhãoJuliano Novaes CardosoSolange de Sousa AndradeWilson Jacob FilhoAntonio Carlos Pereira BarrettoAdvanced heart failure primarily manifests during and after hospitalization for decompensation. Identifying prognostic factors is crucial for distinguishing patients who may benefit from drug therapy from those with end-stage disease. This study aimed to evaluate the prognostic significance of systemic vasoconstriction in patients with decompensated heart failure with a reduced ejection fraction. We evaluated patients hospitalized for decompensated heart failure with a left ventricular ejection fraction of < 40% who underwent non-invasive hemodynamic monitoring using the Modelflow method. The primary endpoint was all-cause mortality, and the data were analyzed using logistic regression. This study included 58 patients (71% men) with a mean age of 58.9 years, an ejection fraction of 23.4%, a median B-type natriuretic peptide of 1,005.0 pg/mL (interquartile range = 1,498.0), and 43% with Chagas disease. The cardiac index was 2.7 L∙min-1∙m-2, and the systemic vascular resistance index was 2,403.9 dyn∙s∙cm-5∙m-2. Over an average follow-up of 29.0 months, 51 (87.9%) patients died. Assessing three-year mortality, high systemic vascular resistance indices were predictive of events with a relative risk of 3.9 (95% confidence interval = 1.1-13.9; P-value = 0.037). In conclusion, non-invasive hemodynamic monitoring identifies systemic vasoconstriction, which is associated with poor prognosis in patients with advanced heart failure and reduced ejection fraction.https://doi.org/10.1371/journal.pone.0312582
spellingShingle Marcelo Eidi Ochiai
Kelly Regina Vieira Novaes
Lucas Hideki Kato Myakava
Marcelo Villaça Lima
Euler Cristovan Ochiai Brancalhão
Juliano Novaes Cardoso
Solange de Sousa Andrade
Wilson Jacob Filho
Antonio Carlos Pereira Barretto
Systemic vasoconstriction and mortality in patients with heart failure and reduced ejection fraction: A cohort of patients who underwent non-invasive hemodynamic monitoring.
PLoS ONE
title Systemic vasoconstriction and mortality in patients with heart failure and reduced ejection fraction: A cohort of patients who underwent non-invasive hemodynamic monitoring.
title_full Systemic vasoconstriction and mortality in patients with heart failure and reduced ejection fraction: A cohort of patients who underwent non-invasive hemodynamic monitoring.
title_fullStr Systemic vasoconstriction and mortality in patients with heart failure and reduced ejection fraction: A cohort of patients who underwent non-invasive hemodynamic monitoring.
title_full_unstemmed Systemic vasoconstriction and mortality in patients with heart failure and reduced ejection fraction: A cohort of patients who underwent non-invasive hemodynamic monitoring.
title_short Systemic vasoconstriction and mortality in patients with heart failure and reduced ejection fraction: A cohort of patients who underwent non-invasive hemodynamic monitoring.
title_sort systemic vasoconstriction and mortality in patients with heart failure and reduced ejection fraction a cohort of patients who underwent non invasive hemodynamic monitoring
url https://doi.org/10.1371/journal.pone.0312582
work_keys_str_mv AT marceloeidiochiai systemicvasoconstrictionandmortalityinpatientswithheartfailureandreducedejectionfractionacohortofpatientswhounderwentnoninvasivehemodynamicmonitoring
AT kellyreginavieiranovaes systemicvasoconstrictionandmortalityinpatientswithheartfailureandreducedejectionfractionacohortofpatientswhounderwentnoninvasivehemodynamicmonitoring
AT lucashidekikatomyakava systemicvasoconstrictionandmortalityinpatientswithheartfailureandreducedejectionfractionacohortofpatientswhounderwentnoninvasivehemodynamicmonitoring
AT marcelovillacalima systemicvasoconstrictionandmortalityinpatientswithheartfailureandreducedejectionfractionacohortofpatientswhounderwentnoninvasivehemodynamicmonitoring
AT eulercristovanochiaibrancalhao systemicvasoconstrictionandmortalityinpatientswithheartfailureandreducedejectionfractionacohortofpatientswhounderwentnoninvasivehemodynamicmonitoring
AT julianonovaescardoso systemicvasoconstrictionandmortalityinpatientswithheartfailureandreducedejectionfractionacohortofpatientswhounderwentnoninvasivehemodynamicmonitoring
AT solangedesousaandrade systemicvasoconstrictionandmortalityinpatientswithheartfailureandreducedejectionfractionacohortofpatientswhounderwentnoninvasivehemodynamicmonitoring
AT wilsonjacobfilho systemicvasoconstrictionandmortalityinpatientswithheartfailureandreducedejectionfractionacohortofpatientswhounderwentnoninvasivehemodynamicmonitoring
AT antoniocarlospereirabarretto systemicvasoconstrictionandmortalityinpatientswithheartfailureandreducedejectionfractionacohortofpatientswhounderwentnoninvasivehemodynamicmonitoring