Heart failure & cardiomyopathiesCohort study
Association of Pulmonary Artery Pressures With Mortality in Adults With Reduced Left Ventricular Ejection Fraction
- Retrospective cohort study
- clinical registry
Authors' conclusion
The authors demonstrate the prevalence and negative prognostic impact of increasingly elevated TRV levels in individuals with reduced LVEF, with a threshold for mortality lying within the range of "borderline risk" PHT.
Study context
- Population
- Adults with reduced left ventricular ejection fraction (LVEF) (<50%) and recorded TRV, National Echocardiography Database of Australia
- Participants
- 23,675 adults
- Exposure
- Increasing pulmonary hypertension (PHT) risk categories by TRV vs normal TRV
- Normaln = 8,801reference
- Borderlinen = 7,061
- Intermediaten = 5,676
- High-riskn = 2,137
- Outcome
- All-cause mortality
- Follow-up
- Median 2.9 years (Q1-Q3: 1.0-5.4 years)
Main finding
As reported in the abstract
Mortality (adjusted HR vs normal TRV)
Each group vs normalAdjusted hazard ratio (95% CI)
Borderline
1.31(1.23–1.38)
Intermediate
1.82(1.72–1.93)
High-risk
2.38(2.21–2.56)
Observational data: associations, not effects.
Further findings
| Outcome | adjusted HR (95% CI) | |
|---|---|---|
| Mortality threshold, TRV >2.41 m/s | 1.18 (1.04–1.33) | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Normal | Borderline | Intermediate | High-risk | Estimate |
|---|---|---|---|---|---|
| 1- and 5-year actuarial mortality, normal to severely elevated TRV · 1 and 5 years | |||||
| 1-year mortality | 13.3% | Not reported in the abstract | Not reported in the abstract | 41.5% | |
| 5-year mortality | 43.8% | Not reported in the abstract | Not reported in the abstract | 81.4% |
- 1- and 5-year actuarial mortality, normal to severely elevated TRV: P < 0.0001
Original publication
Association of Pulmonary Artery Pressures With Mortality in Adults With Reduced Left Ventricular Ejection Fraction. JACC Heart Fail. Published 20 March 2024. doi:10.1016/j.jchf.2024.01.016
Summarised from the published abstract; every number is checked against it