Non-invasive measurement of right atrial pressure by near-infrared spectroscopy: preliminary experience. A report from the SICA-HF study

Pellicori, Pierpaolo and Clark, Andrew L. and Kallvikbacka-Bennett, Anna and Zhang, Jufen and Urbinati, Alessia and Monzo, Luca and Dierckx, Riet and Anker, Stefan D. and Cleland, John G.F. (2017) Non-invasive measurement of right atrial pressure by near-infrared spectroscopy: preliminary experience. A report from the SICA-HF study. European Journal of Heart Failure. ISSN 1388-9842

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Official URL: https://doi.org/10.1002/ejhf.825

Abstract

To assess the clinical value of measuring right atrial pressure (RAP) using near-infrared spectroscopy (NIRS) in patients with chronic heart failure (CHF). Methods and results RAP was measured non-invasively using NIRS over the external jugular vein (Venus 1000, Mespere LifeSciences, Canada) in ambulatory patients with CHF enrolled in the Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF) programme. Comparing 243 patients with CHF (mean age 71 years; mean left ventricular ejection fraction (LVEF) 45%, median NT-proBNP 788 ng/L) to 49 controls (NT-proBNP ≤125 ng/L), RAP was 7 [interquartile range (IQR) 4–11] mmHg vs. 4 (IQR 3–8) mmHg (P < 0.001). Those with RAP ≥10 mmHg (n = 75) were older, had more severe clinical congestion and renal dysfunction, higher plasma NT-proBNP, larger left atrial volume, higher systolic pulmonary pressure and were more often in atrial fibrillation but their LVEF was similar to patients with lower RAP. During a median follow-up of 595 (IQR: 492–714) days, 49 patients (20%) died or were hospitalized for worsening CHF. Compared with patients with RAP ≤5 mmHg, those with RAP ≥10 mmHg had a greater risk of an event (hazard ratio 2.38, 95% confidence interval 1.19–4.75, P = 0.014). RAP measured by NIRS predicted outcome, competing with NT-proBNP in multivariable models. Conclusions Measuring RAP using NIRS identifies ambulatory patients with CHF who have more severe congestion and a worse outcome. The device might be a useful objective method of monitoring RAP, especially for those inexperienced in eliciting physical signs or when measurement of natriuretic peptides is not immediately available

Item Type: Journal Article
Keywords: Heart failure, Near-infrared spectroscopy, Right atrial pressur
Faculty: Faculty of Medical Science
Depositing User: Unnamed user with email Jufen.Zhang@anglia.ac.uk
Date Deposited: 04 May 2017 13:27
Last Modified: 04 May 2017 13:27
URI: http://arro.anglia.ac.uk/id/eprint/701723

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