Prognostic Value of Non-invasive Pulmonary Artery Pulsatility Index (PAPI) in Egyptian Hospitalized Patients with Decompensated Chronic Heart Failure

Background: Assessment of the prognostic role of non-invasive pulmonary artery pulsatility index (PAPI) estimated by echocardiography is important to predict clinical outcome and prognosis in hospitalized patients with decompensated chronic heart failure during hospital course and after hospital dischargePatients and Methods: The study included 115 patients who were hospitalized with decompensated chronic heart failure (DHF) which is defined as impairment of left ventricular systolic function less than 40% estimated by echocardiography and development of rapid and progressive deterioration in signs and symptoms of heart failure, resulting in unplanned office or emergency room visits of these patients then hospitalization. PAPI was calculated by an echocardiographic equation as the ratio of (difference between pulmonary artery systolic pressure and pulmonary artery diastolic pressure) to right atrial pressureResults: PAPI values below the cut-off value (2.7) had sensitivity 85.7% and specificity 88.9% (AUC=0.937, P value< 0.00) to predict poor prognosis and worse clinical outcome in hospitalized patients with DHF and after hospital discharge for six months follow up compared with KCCQ score values.Conclusion: Non-invasive PAPI had a prognostic role to predict adverse cardiac events in hospitalized patients with DHF such as cardiogenic shock, life threatening arrhythmias, myocardial infarction, cerebrovascular stroke, in-hospital mortality, heart failure rehospitalization and mortality after discharge for six months of follow up.