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Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients
Arterial stiffness and subendocardial perfusion impairment may play a significant role in heart failure (HF) outcomes. The aim of the study was to examine the main predictors of 30-day readmission in geriatric patients, hospitalized with HF, explore hemodynamical parameters, arterial stiffness index...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249084/ https://www.ncbi.nlm.nih.gov/pubmed/35783827 http://dx.doi.org/10.3389/fcvm.2022.918601 |
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author | Fantin, Francesco Giani, Anna Franconi, Arianna Zoico, Elena Urbani, Silvia Rossi, Andrea P. Mazzali, Gloria Zamboni, Mauro |
author_facet | Fantin, Francesco Giani, Anna Franconi, Arianna Zoico, Elena Urbani, Silvia Rossi, Andrea P. Mazzali, Gloria Zamboni, Mauro |
author_sort | Fantin, Francesco |
collection | PubMed |
description | Arterial stiffness and subendocardial perfusion impairment may play a significant role in heart failure (HF) outcomes. The aim of the study was to examine the main predictors of 30-day readmission in geriatric patients, hospitalized with HF, explore hemodynamical parameters, arterial stiffness indexes, and subendocardial viability ratio (SEVR). In total, 41 hospitalized patients, affected by HF, were included; they underwent clinical evaluation, routine laboratory testing, and echocardiography. At the time of admission, after the achievement of clinical stability (defined as switching from intravenous to oral diuretic therapy), and at discharge, arterial tonometry was performed to evaluate carotid-femoral pulse wave velocity (PWVcf) and SEVR (then corrected for hemoglobin concentration and oxygen saturation). Through the evaluations, a significant progressive decrease in PWVcf was described (17.79 ± 4.49, 13.54 ± 4.54, and 9.94 ± 3.73 m/s), even after adjustment for age, gender, mean arterial pressure (MAP) variation, and left ventricular ejection fraction (LVEF). A significant improvement was registered for both SEVR (83.48 ± 24.43, 97.94 ± 26.84, and 113.29 ± 38.02) and corrected SEVR (12.74 ± 4.69, 15.71 ± 5.30, and 18.55 ± 6.66) values, and it was still significant when adjusted for age, gender, MAP variation, and LVEF. After discharge, 26.8% of patients were readmitted within 30 days. In a multivariate binary logistic regression analysis, PWVcf at discharge was the only predictor of 30-day readmission (odds ratio [OR] 1.957, 95% CI 1.112–3.443). In conclusion, medical therapy seems to improve arterial stiffness and subendocardial perfusion in geriatric patients hospitalized with heart failure. Furthermore, PWVcf is a valid predictor of 30-day readmission. Its feasibility in clinical practice may provide an instrument to detect patients with HF at high risk of rehospitalization. |
format | Online Article Text |
id | pubmed-9249084 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-92490842022-07-02 Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients Fantin, Francesco Giani, Anna Franconi, Arianna Zoico, Elena Urbani, Silvia Rossi, Andrea P. Mazzali, Gloria Zamboni, Mauro Front Cardiovasc Med Cardiovascular Medicine Arterial stiffness and subendocardial perfusion impairment may play a significant role in heart failure (HF) outcomes. The aim of the study was to examine the main predictors of 30-day readmission in geriatric patients, hospitalized with HF, explore hemodynamical parameters, arterial stiffness indexes, and subendocardial viability ratio (SEVR). In total, 41 hospitalized patients, affected by HF, were included; they underwent clinical evaluation, routine laboratory testing, and echocardiography. At the time of admission, after the achievement of clinical stability (defined as switching from intravenous to oral diuretic therapy), and at discharge, arterial tonometry was performed to evaluate carotid-femoral pulse wave velocity (PWVcf) and SEVR (then corrected for hemoglobin concentration and oxygen saturation). Through the evaluations, a significant progressive decrease in PWVcf was described (17.79 ± 4.49, 13.54 ± 4.54, and 9.94 ± 3.73 m/s), even after adjustment for age, gender, mean arterial pressure (MAP) variation, and left ventricular ejection fraction (LVEF). A significant improvement was registered for both SEVR (83.48 ± 24.43, 97.94 ± 26.84, and 113.29 ± 38.02) and corrected SEVR (12.74 ± 4.69, 15.71 ± 5.30, and 18.55 ± 6.66) values, and it was still significant when adjusted for age, gender, MAP variation, and LVEF. After discharge, 26.8% of patients were readmitted within 30 days. In a multivariate binary logistic regression analysis, PWVcf at discharge was the only predictor of 30-day readmission (odds ratio [OR] 1.957, 95% CI 1.112–3.443). In conclusion, medical therapy seems to improve arterial stiffness and subendocardial perfusion in geriatric patients hospitalized with heart failure. Furthermore, PWVcf is a valid predictor of 30-day readmission. Its feasibility in clinical practice may provide an instrument to detect patients with HF at high risk of rehospitalization. Frontiers Media S.A. 2022-06-17 /pmc/articles/PMC9249084/ /pubmed/35783827 http://dx.doi.org/10.3389/fcvm.2022.918601 Text en Copyright © 2022 Fantin, Giani, Franconi, Zoico, Urbani, Rossi, Mazzali and Zamboni. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Cardiovascular Medicine Fantin, Francesco Giani, Anna Franconi, Arianna Zoico, Elena Urbani, Silvia Rossi, Andrea P. Mazzali, Gloria Zamboni, Mauro Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients |
title | Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients |
title_full | Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients |
title_fullStr | Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients |
title_full_unstemmed | Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients |
title_short | Arterial Stiffness, Subendocardial Impairment, and 30-Day Readmission in Heart Failure Older Patients |
title_sort | arterial stiffness, subendocardial impairment, and 30-day readmission in heart failure older patients |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9249084/ https://www.ncbi.nlm.nih.gov/pubmed/35783827 http://dx.doi.org/10.3389/fcvm.2022.918601 |
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