Left ventricular ejection time in acute heart failure complicating precapillary pulmonary hypertension

Area of Science:

• Cardiology
• Critical Care Medicine
• Pulmonary Hypertension Research

Background:

• Pulmonary hypertension (PH) with heart failure presents management challenges.
• Right ventricle overload in PH reduces stroke volume and shortens left ventricular ejection time (LVET).
• Noninvasive tools are needed to assess prognosis in PH patients with heart failure.

Purpose of the Study:

• To test the hypothesis that LVET has prognostic value in patients with precapillary PH and heart failure.
• To evaluate LVET as a noninvasive predictor of outcomes in the intensive care unit (ICU).

Main Methods:

• Prospective study of 53 consecutive PH patients admitted to the ICU.
• Radial artery tonometry was used to measure LVET from reconstructed aortic pressure curves.
• Clinical and biologic variables were collected at admission and follow-up.

Main Results:

• ICU mortality was 17%. Shorter LVET at admission was significantly associated with unfavorable outcomes (P = .032).
• LVET at entry demonstrated 73% sensitivity and 89% specificity for predicting ICU death.
• Other factors like higher BNP, creatinine, and lower natremia also indicated poor prognosis.

Conclusions:

• Shortened LVET at ICU admission is a significant prognostic factor in precapillary PH with heart failure.
• This finding supports LVET as a valuable noninvasive marker for risk stratification.
• Established prognostic factors were confirmed in this patient cohort.