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Clinical and Prognostic Significance of Positive Hepatojugular Reflux on Discharge in Acute Heart Failure: Insights from the ESCAPE Trial
Joint Authors
Source
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-02-21
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Background.
There has been a decline in emphasis of the value of physical examination in heart failure (HF) with increased reliance on cardiac imaging.
We aim to study the clinical and prognostic significance of positive hepatojugular reflux (HJR) on discharge in patients hospitalized with HF.
Methods.
Using the ESCAPE trial data, patients were compared according to the presence or absence of a positive HJR on discharge.
The primary study endpoints were all-cause mortality and a composite endpoint of death, rehospitalization, and cardiac transplant during the first 6 months after discharge.
Results.
Among 392 patients (age: 56 years, 74% men), the HJR correlated well with clinical and objective hemodynamic markers of volume overload including right atrial pressure (RAP, P = 0.002 ), pulmonary capillary wedge pressure (PCWP, P = 0.006 ), and inferior vena cava size during inspiration ( P = 0.005 ) and expiration ( P = 0.003 ).
The RAP had the highest AUC for predicting a positive HJR on admission (AUC: 0.655, P = 0.004 ) and discharge (AUC: 0.672, P = 0.001 ).
Cox’s proportional hazards analysis revealed that a positive HJR on discharge is an independent predictor of 6-month mortality (estimated hazard ratio: 1.689; 95% CI: 1.032–2.764; P = 0.037 ) after adjusting for age, baseline creatinine, baseline hematocrit, baseline NYHA class, chronic obstructive pulmonary disease, and the presence of tricuspid regurgitation.
Conclusion.
The HJR should be routinely checked in patients admitted with acute HF throughout hospitalization and especially on discharge as it serves as an important prognostic marker for postdischarge outcomes.
American Psychological Association (APA)
Omar, Hesham R.& Guglin, Maya. 2017. Clinical and Prognostic Significance of Positive Hepatojugular Reflux on Discharge in Acute Heart Failure: Insights from the ESCAPE Trial. BioMed Research International،Vol. 2017, no. 2017, pp.1-8.
https://search.emarefa.net/detail/BIM-1137738
Modern Language Association (MLA)
Omar, Hesham R.& Guglin, Maya. Clinical and Prognostic Significance of Positive Hepatojugular Reflux on Discharge in Acute Heart Failure: Insights from the ESCAPE Trial. BioMed Research International No. 2017 (2017), pp.1-8.
https://search.emarefa.net/detail/BIM-1137738
American Medical Association (AMA)
Omar, Hesham R.& Guglin, Maya. Clinical and Prognostic Significance of Positive Hepatojugular Reflux on Discharge in Acute Heart Failure: Insights from the ESCAPE Trial. BioMed Research International. 2017. Vol. 2017, no. 2017, pp.1-8.
https://search.emarefa.net/detail/BIM-1137738
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1137738