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Central venous pressure at emergency room presentation predicts cardiac rehospitalization in patients with decompensated heart failure
Author(s) -
Uthoff Heiko,
Thalhammer Christoph,
Potocki Mihael,
Reichlin Tobias,
Noveanu Markus,
Aschwanden Markus,
Staub Daniel,
Arenja Nisha,
Socrates Thenral,
Twerenbold Raphael,
MutschmannSanchez Sarah,
Heinisch Corinna,
Jaeger Kurt A.,
Mebazaa Alexandre,
Mueller Christian
Publication year - 2010
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1093/eurjhf/hfq024
Subject(s) - medicine , central venous pressure , acute decompensated heart failure , cardiology , heart failure , proportional hazards model , univariate analysis , cardiac function curve , blood pressure , heart rate , multivariate analysis
Aims To investigate the relationship between central venous pressure (CVP) at presentation to the emergency room (ER) and the risk of cardiac rehospitalization and mortality in patients with decompensated heart failure (DHF). Methods and results Central venous pressure was determined non‐invasively using high‐resolution compression sonography at presentation in 100 patients with DHF. Cardiac hospitalizations and cardiac and all‐cause mortality were assessed as a function of continuous CVP levels and predefined CVP categories (low <6 cm H 2 O, intermediate 6–23 cm H 2 O, and high >23 cm H 2 O). Endpoints were adjudicated blinded to CVP. At presentation, mean age was 78 ± 11 years, 60% of patients were male, mean B‐type natriuretic peptide level was 1904 ± 1592 pg/mL, and mean CVP was 13.7 ± 7.0 cm H 2 O (range 0–33). During follow‐up (median 12 months), 25 cardiac rehospitalizations, 26 cardiac deaths, and 7 non‐cardiac deaths occurred. Univariate and stepwise multivariate Cox regression analysis revealed an independent relationship between CVP and cardiac rehospitalization (HR 1.09, 95% CI 1.01–1.18, P = 0.034). Kaplan–Meier analyses confirmed a stepwise increase in cardiac rehospitalization for low‐to‐high CVP (log‐rank test P = 0.015). No association between CVP and (cardiac) mortality was detectable. Conclusion Central venous pressure at ER presentation in patients with DHF is an independent predictor of cardiac rehospitalization but not of cardiac and all‐cause mortality.