Central venous pressure at emergency room presentation predicts cardiac rehospitalization in patients with decompensated heart failure

作者：Uthoff Heiko; Thalhammer Christoph; Potocki Mihael; Reichlin Tobias; Noveanu Markus; Aschwanden Markus; Staub Daniel; Arenja Nisha; Socrates Thenral; Twerenbold Raphael; Mutschmann Sanchez Sarah; Heinisch Corinna; Jaeger Kurt A; Mebazaa Alexandre; Mueller Christian^*

来源：European Journal of Heart Failure, 2010, 12(5): 469-476.

DOI：10.1093/eurjhf/hfq024

• Decompensated heart failure
• Central venous pressure
• Compression sonography
• Emergency room
• Hospitalization
• Mortality

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).
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.
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.

• 出版日期2010-5