Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure

Zübeyde Bayram; Süleyman Çağan Efe; Ali Karagöz; Cem Doğan; Büşra Güvendi; Samet Uysal; Rezzan Deniz Acar; Özgur Yaşar Akbal; Fatih Yılmaz; Hacer Ceren Tokgöz; Mehmet Kaan Kırali; Cihangir Kaymaz; Nihal Özdemir

doi:10.51645/khj.2021.m106

Zübeyde Bayram^¹, Süleyman Çağan Efe^¹, Ali Karagöz^¹, Cem Doğan^¹, Büşra Güvendi^¹, Samet Uysal^¹, Rezzan Deniz Acar^¹, Özgur Yaşar Akbal^¹, Fatih Yılmaz^¹, Hacer Ceren Tokgöz^¹, Mehmet Kaan Kırali^², Cihangir Kaymaz^¹, Nihal Özdemir^¹

¹Department of Cardiology, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
²Department of Cardiovascular Surgery, Kartal Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey

Keywords: Clinical outcome; end-stage heart failure; heart failure etiology; ischemic cardiomyopathy; non-ischemic cardiomyopathy; right ventricular function

Abstract

Introduction: The aim of this study was to investigate the effect of heart failure (HF) etiology on clinical, echocardiographic, and hemodynamic findings, right ventricular (RV) function, and outcomes in patients with end-stage HF.
Patients and Methods: A total of 470 end-stage HF patients who undergoing evaluation for heart transplantation (HT) were divided into two groups: ischemic cardiomyopathy (ICMP, n= 249) and nonischemic cardiomyopathy (NICMP, n= 221). RV dysfunction was defined as tricuspid annular plane systolic excursion (TAPSE) ≤ 1.5 cm (TAPSE-defined RV dysfunction) and right ventricular stroke work index (RVSWI) < 5 g/m/beat/m2 (RVSWI-defined RV dysfunction). The primary outcome was defined as left ventricular assist device implantation, urgent HT, or death.
Results: Patients with ICMP had higher pulmonary vascular resistance, systolic and mean pulmonary artery pressures (PAPs and PAPm) than those with NICMP [3.0 (1.1-6.0) vs. 2.0 (1.0-5.0), p= 0.013; 53.5 (42.0-68.0) vs. 46.0 (32.5-64.5), p< 0.001 and 35.512.9 vs. 31.812.3, p= 0.002]. RVSWI levels were lower in NICMP patients than in ICMP patients [5.4 (3.7-7.6) vs. 6.5 (4.6-9.6), p< 0.001]. While TAPSE-defined RV dysfunction was comparable between NICMP and ICMP, RVSWI-defined RV dysfunction was higher in NICMP (44.3% vs. 55.0%, p= 0.069 and 45.2% vs. 31.3%, p= 0.012). NICMP was an independent predictor for RVSWI-defined RV dysfunction, but not for TAPSE-defined RV dysfunction, according to multivariate analyses (OR: 1.79, 95% CI: 1.13-2.82, p= 0.012 and OR: 0.63, 95% CI: 0.28-1.39, p= 0.254). Over a median follow-up of 503.5 days, it was demonstrated that HF etiology was not a predictor of primary outcome according to unadjusted and adjusted models (OR: 0.99, 95% CI: 0.80-1.23, p= 0.936 and OR: 0.89, 95% CI: 0.60-1.31, p= 0.542).
Conclusion: We that demonstrated patients with end-stage HF, ICMP had greater RV afterload and RVSWI value than NICMP and HF etiology was not predictor of primary outcome. However, we couldn’t say for sure whether HF etiology has an effect on RV function because of the conflicting results in TAPSE-defined RV dysfunction and RVSWI-defined RV dysfunction.

Ethics Committee Approval

This study was approved by the Local Ethical Commitee (approval number: 2017.3/9-32 date: 08.05.2017).

Informed Consent

Informed consent was obtained.

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - ZB, CD, NÖ; Analysis/ Interpretation - ZB, SE, AK; Data Collection - ZB, SU, BG, FY, ÖA; Writing - ZB, HT, RA; Critical Revision - NÖ, CK, MK; Statistical Analysis - ZB, AK; Overall Responsibility - ZB; Final Approval - All of Authors.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declared that this study has received no financial support.

BibTex	@article{ kosuyolu_heart_j1790, doi = {10.51645/khj.2021.m106}, author = {Zübeyde Bayram, Süleyman Çağan Efe, Ali Karagöz, Cem Doğan, Büşra Güvendi, Samet Uysal, Rezzan Deniz Acar, Özgur Yaşar Akbal, Fatih Yılmaz, Hacer Ceren Tokgöz, Mehmet Kaan Kırali, Cihangir Kaymaz, Nihal Özdemir}, title = {Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure}, journal = {Koşuyolu Heart J}, year = {2021}, volume = {24}, number = {3}, pages = {206-215}, publisher = {Kartal Koşuyolu High Specialization Training and Research Hospital} }
RIS	TY - JOUR AU - Zübeyde Bayram, Süleyman Çağan Efe, Ali Karagöz, Cem Doğan, Büşra Güvendi, Samet Uysal, Rezzan Deniz Acar, Özgur Yaşar Akbal, Fatih Yılmaz, Hacer Ceren Tokgöz, Mehmet Kaan Kırali, Cihangir Kaymaz, Nihal Özdemir PY - 2021 TI - Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure SP - 206 EP - 215 JO - Koşuyolu Heart Journal J2 - Koşuyolu Heart J VL - 24 IS - 3 PB - DO - 10.51645/khj.2021.m106 ER -
EndNote	`%0 Journal Article %A Zübeyde Bayram, Süleyman Çağan Efe, Ali Karagöz, Cem Doğan, Büşra Güvendi, Samet Uysal, Rezzan Deniz Acar, Özgur Yaşar Akbal, Fatih Yılmaz, Hacer Ceren Tokgöz, Mehmet Kaan Kırali, Cihangir Kaymaz, Nihal Özdemir %T Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure %J Koşuyolu Heart Journal %D 2021 %V 24 %N 3 %P 206-215 %R 10.51645/khj.2021.m106`
APA	Zübeyde Bayram, Süleyman Çağan Efe, Ali Karagöz, Cem Doğan, Büşra Güvendi, Samet Uysal, Rezzan Deniz Acar, Özgur Yaşar Akbal, Fatih Yılmaz, Hacer Ceren Tokgöz, Mehmet Kaan Kırali, Cihangir Kaymaz, Nihal Özdemir (2021). Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure. Koşuyolu Heart Journal, 24(3), 206-215. doi:10.51645/khj.2021.m106
MLA	Zübeyde Bayram, Süleyman Çağan Efe, Ali Karagöz, Cem Doğan, Büşra Güvendi, Samet Uysal, Rezzan Deniz Acar, Özgur Yaşar Akbal, Fatih Yılmaz, Hacer Ceren Tokgöz, Mehmet Kaan Kırali, Cihangir Kaymaz, Nihal Özdemir. "Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure" Koşuyolu Heart Journal, vol. 24, no. 3, 2021, pp. 206-215. doi:10.51645/khj.2021.m106.
Chicago	Zübeyde Bayram, Süleyman Çağan Efe, Ali Karagöz, Cem Doğan, Büşra Güvendi, Samet Uysal, Rezzan Deniz Acar, Özgur Yaşar Akbal, Fatih Yılmaz, Hacer Ceren Tokgöz, Mehmet Kaan Kırali, Cihangir Kaymaz, Nihal Özdemir. "Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure" Koşuyolu Heart Journal 24, no. 3 (2021): 206-215. https://doi.org/10.51645/khj.2021.m106.
AMA	Zübeyde Bayram, Süleyman Çağan Efe, Ali Karagöz, Cem Doğan, Büşra Güvendi, Samet Uysal, Rezzan Deniz Acar, Özgur Yaşar Akbal, Fatih Yılmaz, Hacer Ceren Tokgöz, Mehmet Kaan Kırali, Cihangir Kaymaz, Nihal Özdemir. Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure. Koşuyolu Heart J. 2021; 24(3): 206-215. doi:10.51645/khj.2021.m106.
Vancouver	Zübeyde Bayram, Süleyman Çağan Efe, Ali Karagöz, Cem Doğan, Büşra Güvendi, Samet Uysal, Rezzan Deniz Acar, Özgur Yaşar Akbal, Fatih Yılmaz, Hacer Ceren Tokgöz, Mehmet Kaan Kırali, Cihangir Kaymaz, Nihal Özdemir. Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure. Koşuyolu Heart J. 2021; 24(3): 206-215. doi:10.51645/khj.2021.m106

Differences in Clinical Features, Hemodynamic Findings and Clinical Outcomes of Ischemic and Non-ischemic Cardiomyopathy in End-Stage Heart Failure

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