PMID- 29019615
OWN - NLM
STAT- MEDLINE
DCOM- 20180618
LR  - 20220316
IS  - 1522-9645 (Electronic)
IS  - 0195-668X (Linking)
VI  - 38
IP  - 38
DP  - 2017 Oct 7
TI  - Haemodynamic profiles of children with end-stage heart failure.
PG  - 2900-2909
LID - 10.1093/eurheartj/ehx456 [doi]
AB  - AIMS: To evaluate associations between haemodynamic profiles and symptoms, 
      end-organ function and outcome in children listed for heart transplantation. 
      METHODS AND RESULTS: Children <18 years listed for heart transplant between 1993 
      and 2013 with cardiac catheterization data [pulmonary capillary wedge pressure 
      (PCWP), right atrial pressure (RAP), and cardiac index (CI)] in the Pediatric 
      Heart Transplant Study database were included. Outcomes were New York Heart 
      Association (NYHA)/Ross classification, renal and hepatic dysfunction, and death 
      or clinical deterioration while on waitlist. Among 1059 children analysed, median 
      age was 6.9 years and 46% had dilated cardiomyopathy. Overall, 58% had congestion 
      (PCWP >15 mmHg), 28% had severe congestion (PCWP >22 mmHg), and 22% low cardiac 
      output (CI < 2.2 L/min/m2). Twenty-one per cent met the primary outcome of death 
      (9%) or clinical deterioration (12%). In multivariable analysis, worse NYHA/Ross 
      classification was associated with increased PCWP [odds ratio (OR) 1.03, 95% 
      confidence interval (95% CI) 1.01-1.07, P = 0.01], renal dysfunction with 
      increased RAP (OR 1.04, 95% CI 1.01-1.08, P = 0.007), and hepatic dysfunction 
      with both increased PCWP (OR 1.03, 95% CI 1.01-1.06, P < 0.001) and increased RAP 
      (OR 1.09, 95% CI 1.06-1.12, P < 0.001). There were no associations with low 
      output. Death or clinical deterioration was associated with severe congestion (OR 
      1.6, 95% CI 1.2-2.2, P = 0.002), but not with CI alone. However, children with 
      both low output and severe congestion were at highest risk (OR 1.9, 95% CI 
      1.1-3.5, P = 0.03). CONCLUSION: Congestion is more common than low cardiac output 
      in children with end-stage heart failure and correlates with NYHA/Ross 
      classification and end-organ dysfunction. Children with both congestion and low 
      output have the highest risk of death or clinical deterioration.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2017. For permissions, please email: journals.permissions@oup.com.
FAU - Chen, Sharon
AU  - Chen S
AD  - Stanford University, 750 Welch Road, Suite 305, Palo Alto, CA 94304, USA.
FAU - Dykes, John C
AU  - Dykes JC
AD  - Stanford University, 750 Welch Road, Suite 305, Palo Alto, CA 94304, USA.
FAU - McElhinney, Doff B
AU  - McElhinney DB
AD  - Stanford University, 750 Welch Road, Suite 305, Palo Alto, CA 94304, USA.
FAU - Gajarski, Robert J
AU  - Gajarski RJ
AD  - Nationwide Children's Hospital, Columbus, OH, USA.
FAU - Shin, Andrew Y
AU  - Shin AY
AD  - Stanford University, 750 Welch Road, Suite 305, Palo Alto, CA 94304, USA.
FAU - Hollander, Seth A
AU  - Hollander SA
AD  - Stanford University, 750 Welch Road, Suite 305, Palo Alto, CA 94304, USA.
FAU - Everitt, Melanie E
AU  - Everitt ME
AD  - Children's Hospital Colorado, Aurora, CO, USA.
FAU - Price, Jack F
AU  - Price JF
AD  - Texas Children's Hospital, Houston, TX, USA.
FAU - Thiagarajan, Ravi R
AU  - Thiagarajan RR
AD  - Boston Children's Hospital, Boston, MA, USA.
FAU - Kindel, Steven J
AU  - Kindel SJ
AD  - Children's Hospital of Wisconsin, Milwaukee, WI, USA.
FAU - Rossano, Joseph W
AU  - Rossano JW
AD  - Children's Hospital of Philadelphia, Philadelphia, PA, USA.
FAU - Kaufman, Beth D
AU  - Kaufman BD
AD  - Stanford University, 750 Welch Road, Suite 305, Palo Alto, CA 94304, USA.
FAU - May, Lindsay J
AU  - May LJ
AD  - Primary Children's Hospital, Salt Lake City, UT, USA.
FAU - Pruitt, Elizabeth
AU  - Pruitt E
AD  - The Pediatric Heart Transplant Study Group, The University of Alabama at 
      Birmingham, Birmingham, AL, USA.
FAU - Rosenthal, David N
AU  - Rosenthal DN
AD  - Stanford University, 750 Welch Road, Suite 305, Palo Alto, CA 94304, USA.
FAU - Almond, Christopher S
AU  - Almond CS
AD  - Stanford University, 750 Welch Road, Suite 305, Palo Alto, CA 94304, USA.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
SB  - IM
CIN - Eur Heart J. 2017 Oct 7;38(38):2910-2911. PMID: 29019618
MH  - Adolescent
MH  - Cardiac Output, Low/mortality/physiopathology
MH  - Cardiomyopathies/complications/mortality/physiopathology
MH  - Child
MH  - Child, Preschool
MH  - Chronic Disease
MH  - Clinical Deterioration
MH  - Female
MH  - Heart Failure/complications/mortality/*physiopathology
MH  - Heart Ventricles/abnormalities
MH  - Hemodynamics/*physiology
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
OTO - NOTNLM
OT  - Haemodynamics
OT  - Paediatric heart failure
EDAT- 2017/10/12 06:00
MHDA- 2018/06/19 06:00
CRDT- 2017/10/12 06:00
PHST- 2017/02/01 00:00 [received]
PHST- 2017/07/18 00:00 [accepted]
PHST- 2017/10/12 06:00 [entrez]
PHST- 2017/10/12 06:00 [pubmed]
PHST- 2018/06/19 06:00 [medline]
AID - 4084240 [pii]
AID - 10.1093/eurheartj/ehx456 [doi]
PST - ppublish
SO  - Eur Heart J. 2017 Oct 7;38(38):2900-2909. doi: 10.1093/eurheartj/ehx456.