Pulmonary Artery Pulsatility Index As A Predictor Of Cardiac Mortality In Advanced Chronic Heart Failure: Is It Beyond Right Atrial Pressure?

Year 2020, , 304 - 311, 17.06.2020

Ali Doğan

https://doi.org/10.5798/dicletip.755709

Abstract

Objective: The effect of pulmonary artery pulsatility index (PAPi) on mortality in patients with advanced chronic heart failure (HF).
Methods: The study included 53 patients with advanced chronic HF, with ejection fraction below 30%, who underwent right and left catheterization. Two groups were formed according to the development of cardiac mortality.
Results: Of 53 patients in the study group, 18 patients developed cardiac mortality (33.9%). While male gender and peripheral artery disease were more in the cardiac mortality group, CRP level was also seen more in this group. As stroke volume, aortic pressures, left ventricular systolic pressure were lower in the cardiac mortality group, right atrium pressure (RAP) was higher. PAPi was associated with cardiac mortality and lower in this group (P = 0.001). According to univariate analysis, PAPi and RAP were among predictors of cardiac mortality. However, multivariate analysis indicated that only RAP was an independent predictor. PAPi threshold value for cardiac mortality was calculated as 2.9 (88.9% sensitivity and 74.3% specificity).
Conclusion: PAPi is related with cardiac mortality in advanced HF. However, it is not an independent predictor. PAPi is mostly dependent on right atrial pressure.

Keywords

advanced heart failure, cardiac mortality

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