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Table 3 Clinical, laboratory, functional capacity, echocardiographic and right heart catheterization data on patients with cLVD, dLVD and overt LVF

From: A novel echocardiographic right ventricular dysfunction score can identify hemodynamic severity profiles in left ventricular dysfunction

  Post hoc analysisa
Variable cLVD (n = 42) dLVD (n = 25) LVF (n = 33) Overall p cLVD vs dLVD cLVD vs LVF dLVD vs LVF
Clinical
 Age (years) 53 ± 13 54 ± 15 55 ± 14 0.70 - - -
 Gender (male, %) 71 83 79 0.85 - - -
 Dilated cardiomyopathy (%) 71 44 73 0.33 - - -
 Ischemic heart disease (%) 19 48 18 0.045 0.08 1.0 0.07
 Previous cardiac surgery (%) 5 16 9 0.35 - - -
 Rales (%) 8 22 45 0.045 1.0 0.036 0.54
 Edema (%) 21 18 35 0.55 - - -
Laboratory
 Hemoglobin (g/L) 140 ± 17 130 ± 13 137 ± 16 0.047 0.04 1.00 0.34
 Creatinine (mmol/L) 95 (80; 129) 92 (84; 140) 125 (103; 143) 0.012 1.0 0.02 0.052
 Bilirubin (µmol/L) 8.1 (6.0; 10.6) 12.0 (6.1; 18) 14 (12; 21.5)  < 0.001 0.46  < 0.001 0.058
 NT-proBNP (ng/L) 1120 (571; 2155) 1980 (1280; 3690) 5040 (3340; 8395)  < 0.001 0.09  < 0.001 0.009
Functional capacity
 NYHA group 3–4 (%) 58 88 97 0.15 - - -
 Ergo (W) 90 (76; 120) 90 (74; 109) 65 (53; 85) 0.001 1.0 0.001 0.02
 Peak VO2 (mL/kg/min) 14 (12;18) 14 (11;17) 12 (9–13) 0.002 0.71 0.002 0.11
LV/LA dimension
 LV end-diastolic volume index (ml/m2) 85 (59; 112) 105 (92; 130) 109 (85; 141) 0.009 0.04 0.02 1.0
 Left atrial volume index (ml/m2) 41 (33; 54) 62 (50; 68) 62 (51; 83)  < 0.001 0.001  < 0.001 1.0
LV function
 LV ejection fraction (%) 32 (25; 40) 25 (20; 32) 21 (17; 27)  < 0.001 0.09  < 0.001 0.36
 LV global longitudinal strain (%) -8.1 (-10.8; -6.1) -6.5 (-9.0; -5.1) -5.5 (-6.6; -2.6) 0.001 0.33 0.001 0.18
 Doppler CI (L/min/ m2) 2.0 (1.8; 2.4) 1.8 (1.5; 2.1) 1.6 (1.1; 1.9) 0.001 0.27  < 0.001 0.23
 Proportion with CI < 1.9 L/min/ m2 (%) 28 56 76 0.015 0.11  < 0.001 0.48
 E/E’ 12.1 (7.7; 17.8) 16.8 (13; 19.6) 16.3 (13.5; 21.3) 0.03 0.08 0.08 1.0
 Increased left atrial pressureb (%) 37 90 92 0.028  < 0.001  < 0.001 1.0
 Mitral regurgitation ≥ moderate (%) 21 28 58 0.024 1.0 0.005 0.10
Right heart catheterization
 Heart rate 66 ± 11 73 ± 10 76 ± 12 0.002 0.71 0.002 0.16
 MSAP (mmHg) 74 ± 14 73 ± 10 71 ± 8 0.96 - - -
 Pulse pressure (mmHg) 50 ± 15 47 ± 18 40 ± 13 0.013 0.42 0.010 0.42
 Right atrial pressure (mmHg) 2 (1; 4) 5 (3; 8) 11 (9; 14)  < 0.001 0.008  < 0.001 0.002
 Right atrial pressure ≥ 10 mmHg (%) 2 12 67  < 0.001 0.42  < 0.001  < 0.001
 SPAP (mmHg) 26 ± 7 42 ± 9 49 ± 9  < 0.001  < 0.001  < 0.001 0.20
 MPAP (mmHg) 15 ± 5 28 ± 6 34 ± 6  < 0.001  < 0.001  < 0.001 0.10
 PCWP (mmHg) 6 (4; 10) 18 (16; 21) 23 (20; 25)  < 0.001  < 0.001  < 0.001 0.08
 Right atrial pressure/PCWP 0.31 (0.08; 0.50) 0.29 (0.15; 0.41) 0.48 (0.34; 0.65)  < 0.001 1.0 0.002 0.001
 Stroke volume index (mL/m2) 39 ± 8 33 ± 8 25 ± 7  < 0.001 0.053  < 0.001 0.002
 Cardiac index (L/min/m2) 2.7 ± 0.4 2.6 ± 0.8 2.1 ± 0.4  < 0.001 0.23  < 0.001 0.016
 SaO2 (%) 95 ± 2 95 ± 2 94 ± 3 0.08 - - -
 SvO2 (%) 70 ± 5 65 ± 4 52 ± 5  < 0.001 0.02  < 0.001  < 0.001
 PVR (Wood units) 1.6 (1.2; 1.9) 1.9 (1.2; 2.4) 2.4 (1.8; 3.3)  < 0.001 0.35  < 0.001 0.08
RV/RA dimension
 RVD1 (mm) 42 ± 8 47 ± 10 50 ± 6  < 0.001 0.13  < 0.001 0.23
 RVEDA/BSA (cm2/m2) 9.8 ± 2.5 11.4 ± 4.0 12.3 ± 2.8 0.001 0.28  < 0.001 0.23
 RAAI (cm2/m2) 10.0 ± 3.5 12.3 ± 5.8 13.9 ± 3.6  < 0.001 0.20  < 0.001 0.07
RV function
 5-point RVD score 1 (0; 1) 1(1; 3) 3.0 (2; 4)  < 0.001 0.03  < 0.001 0.002
 IVC collapsibility (%) 79 (55; 100) 64 (40; 78) 26 (17; 39)  < 0.001 0.21  < 0.001 0.004
 S’ velocity (cm/s) 9 (8; 11) 8 (7; 10) 8 (6; 9) 0.12 - - -
 Tricuspid regurgitation ≥ moderate (%) 7 16 45 0.0015 1.0  < 0.001 0.03
  1. Bold represents significant p value
  2. Values are mean ± standard deviation, median (IQR 25%;75%), or numbers and percent as appropriate. A p-value < 0.05 was considered significant
  3. BSA Body surface area, cLVD Compensated left ventricular dysfunction, dLVD decompensated left ventricular dysfunction, E/E’ ratio between early diastolic blood pool and annular velocity, Ergo Ergospirometry work load, GLVStr Global left ventricular strain, LVEDVI Left ventricular end-diastolic volume indexed to body surface area, LV Left ventricle, LVEF Left ventricular ejection fraction, LVF Left ventricular failure, MR Mitral regurgitation, MSAP Mean systemic arterial pressure, MPAP Mean pulmonary artery pressure, NYHA New York Heart Association class, PA Pulmonary artery, PCWP Pulmonary capillary wedge pressure, PVR Pulmonary vascular resistance, RAAI Right atrial area index, RVEDA Right ventricular area in diastole, RVD1 Right ventricular inflow diameter, RVD Right ventricular dysfunction, S’ peak systolic tissue velocity, SvO2 mixed venous oxygen saturation, VO2 maximal oxygen consumption
  4. aPost-hoc analysis significance values have been adjusted by the Bonferroni correction for multiple tests
  5. bIncreased left atrial pressure using the proposed algorithm by the American Society of Echocardiography