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

Pellicori, P. , Clark, A. L., Kallvikbacka-Bennett, A., Zhang, J., Urbinati, A., Monzo, L., Dierckx, R., Anker, S. D. and Cleland, J. 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, 19(7), pp. 883-892. (doi:10.1002/ejhf.825) (PMID:28387033)

[img]
Preview
Text
137890.pdf - Accepted Version

406kB

Abstract

Aims: 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:Articles
Additional Information:The research leading to these results has received funding from the European Union Seventh Framework Programme [FP7/2007-2013] under grant agreement n° 241558 (SICA-HF). The research leading to these results has received funding from the Russian Ministry of Science and Education within the FTP "R&D in priority fields of the S&T complex of Russia 2007-2012" under state contract °02.527.11.0007.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Cleland, Professor John and Pellicori, Dr Pierpaolo
Authors: Pellicori, P., Clark, A. L., Kallvikbacka-Bennett, A., Zhang, J., Urbinati, A., Monzo, L., Dierckx, R., Anker, S. D., and Cleland, J. G.F.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:European Journal of Heart Failure
Publisher:Wiley
ISSN:1388-9842
ISSN (Online):1879-0844
Published Online:06 April 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in European Journal of Heart Failure 19(7):883-892
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

University Staff: Request a correction | Enlighten Editors: Update this record