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Night‐time electromechanical activation time, pulsatile hemodynamics, and discharge outcomes in patients with acute heart failure

Journal Article · · ESC Heart Failure
DOI:https://doi.org/10.1002/ehf2.12044· OSTI ID:1328720
 [1];  [2];  [1];  [3];  [3]
  1. Department of Medicine Taipei Veterans General Hospital Taipei Taiwan, Department of Medicine National Yang‐Ming University Taipei Taiwan
  2. Department of Medicine Taipei Veterans General Hospital Taipei Taiwan, Department of Medicine National Yang‐Ming University Taipei Taiwan, Department of Public Health National Yang‐Ming University Taipei Taiwan
  3. Department of Medical Education Taipei Veterans General Hospital Taipei Taiwan, Cardiovascular Research Center National Yang‐Ming University Taipei Taiwan, Department of Medicine National Yang‐Ming University Taipei Taiwan, Department of Public Health National Yang‐Ming University Taipei Taiwan
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Abstract Aims

Both electromechanical activation time (EMAT) and pulsatile hemodynamics measured during the hospitalization course are useful in the prediction of cardiovascular outcomes in patients with acute heart failure syndrome (AHFS). We investigated whether night‐time monitoring of EMAT with the ambulatory acoustic cardiography is superior to the measures of pulsatile hemodynamics for prediction of AHFS post‐discharge outcomes.

Methods and results

A total of 97 patients (71.1 ± 15.4 years old, 81% male, and 73.8% systolic heart failure) hospitalized for AHFS were included. Before discharge, 24 h ambulatory acoustic cardiography and a comprehensive echocardiographic and pulsatile hemodynamic study were performed to assess the mean 24 h, daytime, and night‐time EMAT, carotid systolic blood pressure (SBP) and pulse pressure (PP), amplitude of the reflected pressure wave from a decomposed carotid pressure wave (Pb), and carotid–femoral pulse wave velocity (cfPWV), in addition to measurement of N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) levels. During a mean follow‐up of 389 ± 281 days, 49 patients (50.5%) experienced events including re‐hospitalization for heart failure, myocardial infarction, stroke, or death. Pulsatile hemodynamics, including carotid SBP and PP and Pb, but not cfPWV, and night‐time EMAT, but not daytime EMAT, significantly predicted post‐discharge events when age and NT‐proBNP were accounted for (all P  < 0.05). In a final model with adjustment for age and NT‐proBNP, night‐time EMAT, but not Pb, significantly predicted post‐discharge events [hazard ratio per 1 SD and 95% confidence intervals: 1.33 (1.05–1.69), P  < 0.05].

Conclusion

Pre‐discharge night‐time EMAT may be a better predictor for post‐discharge adverse events than the measures of the pulsatile hemodynamics in patients with AHFS.

Sponsoring Organization:
USDOE Office of Electricity (OE), Advanced Grid Research & Development. Power Systems Engineering Research
OSTI ID:
1328720
Journal Information:
ESC Heart Failure, Journal Name: ESC Heart Failure Journal Issue: 3 Vol. 2; ISSN 2055-5822
Publisher:
Wiley Blackwell (John Wiley & Sons)Copyright Statement
Country of Publication:
Country unknown/Code not available
Language:
English

References (23)

Does This Dyspneic Patient in the Emergency Department Have Congestive Heart Failure? journal October 2005
Assessment of Systolic and Diastolic Function in Asymptomatic Subjects Using Ambulatory Monitoring With Acoustic Cardiography journal April 2011
Response of atrial natriuretic factor to postural change in patients with heart failure versus subject with normal hemodynamics journal September 1990
Myocardial infarction redefined—a consensus document of The Joint European Society of Cardiology/American College of Cardiology committee for the redefinition of myocardial infarction journal September 2000
Noninvasive single-beat determination of left ventricular end-systolic elastance in humans journal December 2001
Usefulness of systolic time intervals in the identification of abnormal ventriculo-arterial coupling in stable heart failure patients* journal November 2008
Rapid bedside identification of high-risk population in heart failure with reduced ejection fraction by acoustic cardiography journal October 2013
Beyond auscultation: Acoustic cardiography in clinical practice journal April 2014
Impact of Arterial Load and Loading Sequence on Left Ventricular Tissue Velocities in Humans journal October 2007
Acute Heart Failure Syndromes journal February 2009
Association between sleep apnea and overnight hemodynamic changes in hospitalized heart failure patients with and without paroxysmal nocturnal dyspnea journal May 2013
Pulsatile Hemodynamics and Clinical Outcomes in Acute Heart Failure journal July 2011
Brachial-ankle vs carotid-femoral pulse wave velocity as a determinant of cardiovascular structure and function journal June 2007
NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients journal November 2005
ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC journal May 2012
Excessive wave reflections on admission predict post-discharge events in patients hospitalized due to acute heart failure journal December 2012
Noninvasive Prediction of Left Ventricular Systolic Dysfunction in Patients With Clinically Suspected Heart Failure Using Acoustic Cardiography: acoustic cardiography and reduced LVEF journal October 2010
Diurnal variation of pulmonary artery pressure in chronic heart failure. journal July 1989
Quantification of Wave Reflection in the Human Aorta From Pressure Alone: A Proof of Principle journal October 2006
Nocturnal Rostral Fluid Shift: A Unifying Concept for the Pathogenesis of Obstructive and Central Sleep Apnea in Men With Heart Failure journal April 2010
Wave Reflection and Arterial Stiffness in the Prediction of 15-Year All-Cause and Cardiovascular Mortalities: A Community-Based Study journal March 2010
Electromechanical Activation Time in the Prediction of Discharge Outcomes in Patients Hospitalized with Acute Heart Failure Syndrome journal January 2010
Assessment of systolic and diastolic function in heart failure using ambulatory monitoring with acoustic cardiography journal January 2011

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