Aortic Artery Pulsatility Index (API) Estimated by Echocardiography and Prognosis in Patients with Decompensated Heart Failure.

Abstract

Aim of study: Role of noninvasive aortic artery pulsatility index (API) estimated by echocardiography to predict the prognosis in patients who hospitalized with decompensated heart failure (HF) during hospital course and for 3 months after discharge with comparing this prognosis with KCCQ score.

Patients and methods: The study was occurred on 115 patients who hospitalized at Helwan University Badr Hospital with manifestations of decompensated heart failure (DHF) which is defined in patients whose left ventricular systolic function <40% and were stable on their medications then suddenly developed rapid deterioration in symptoms and signs of HF that need hospitalization. API is the ratio of (difference between systemic systolic pressure and systemic diastolic pressure) to pulmonary capillary wedge pressure which detected by echocardiographic equation as 1.9+ (E/é X1.24).

Results: Patients with API values below cutoff value (1.45) had sensitivity 73% and specificity 98% (area under the curve = 0.908, P < 0.00) to predict poor prognosis and worse clinical outcome in patients with DHF during hospital stay and after hospital discharge for 3 months.

Conclusion: Noninvasive API can predict the mortality and various clinical complications as cardiogenic shock, myocardial infarction, fatal arrhythmias, and stroke in patients with DHF during hospital course and HF rehospitalization, mortality after hospital discharge for 3 months.