A higher portal vein pulsatility ratio at discharge was associated with a worse prognosis for cardiac death and heart failure re-hospitalization in patients with acute heart failure (P=0.03).
Observational (n=73)
No
Does a higher portal vein pulsatility ratio at discharge predict worse prognosis in hospitalized patients with acute heart failure?
Portal vein pulsatility ratio assessed by ultrasonography at discharge serves as a novel and useful prognostic marker for predicting cardiac death and re-hospitalization in patients with acute heart failure.
p-value: p== 0.03
BACKGROUND: Heart failure (HF) causes extracardiac organ congestion, including in the hepatic portal system. Reducing venous congestion is essential for HF treatment, but evaluating venous congestion is sometimes difficult in patients with chronic HF. The portal vein (PV) flow pattern can be influenced by right atrial pressure. Ultrasound images of the PV are quite easy to obtain and are reproducible among sonographers. However, the association between PV pulsatility and the condition of HF remains unclear. We hypothesize that PV pulsatility at discharge reflects the condition of HF. AIM: To evaluate the usefulness of PV pulsatility as a prognostic marker for hospitalized patients with acute HF. METHODS: This observational study was conducted from April 2016 to January 2017 and April 2018 to April 2019 at Shinko Hospital. We enrolled 56 patients with acute HF, and 17 patients without HF served as controls. PV flow velocity was measured by ultrasonography on admission and at discharge. We calculated the PV pulsatility ratio (PVPR) as the ratio of the difference between the peak and minimum velocity to the peak velocity. The primary endpoint was cardiac death and HF re-hospitalization. The observation period was 1 year from the first hospitalization. The Kaplan-Meier method was used to determine the stratified composite event-free rates, and the log-rank test was used for comparisons between groups. RESULTS: = 0.03). To elucidate the association between the PVPR and cardiovascular outcomes, the patients were divided into three groups according to the PVPR tertile at discharge (PVPR-T1: 0 ≤ PVPR ≤ 0.08, PVPR-T2: 0.08 0.21). The Kaplan-Meier analysis showed that patients with a higher PVPR at discharge had the worst prognosis among the groups. CONCLUSION: PVPR at discharge reflects the condition of HF. It is also a novel prognostic marker for hospitalized patients with acute HF.
Kuwahara et al. (2023) conducted an observational in acute heart failure (n=73). Portal vein pulsatility ratio (PVPR) vs. Lower PVPR was evaluated on cardiac death and HF re-hospitalization (p== 0.03). A higher portal vein pulsatility ratio at discharge was associated with a worse prognosis for cardiac death and heart failure re-hospitalization in patients with acute heart failure (P=0.03).