Evidence map›Paper›PMID 35534640›Full record

Trial reportHeart and vessels2022

Systemic arterial pulsatility index (SAPi) predicts adverse outcomes in advanced heart failure patients.

Sula Mazimba, Hunter Mwansa, Khadijah Breathett, Jarred E Strickling, Kajal Shah, Coleen McNamara, Nishaki Mehta, Younghoon Kwon, Josephine Lamp, Lu Feng and 8 more

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Heart and vessels, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 7 institutions in 2 countries.

Sula MazimbaDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA. SM8SD@hscmail.mcc.virginia.edu.ORCID http://orcid.org/0000-0001-6451-2118
Hunter MwansaDivision of Internal Medicine, University of Illinois College of Medicine, Peoria, IL, USA.
Khadijah BreathettDivision of Cardiovascular Medicine, Indiana University, Indianapolis, IN, USA.
Jarred E StricklingDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
Kajal ShahDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
Coleen McNamaraDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
Nishaki MehtaDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
Younghoon KwonDivision of Cardiovascular Medicine, University of Washington Medical Center, Seattle, WA, USA.
Josephine LampDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
Lu FengDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
Jose TallajDivision of Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Salpy PamboukianDivision of Cardiovascular Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
Mwenya MubangaDepartment of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Stockholm, Sweden.
Jashanjeet MatharooDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
Scott LimDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
Michael SalernoDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
Victor MwansaDivision of Cardiology, Heartland Regional Medical Group, Marion, IL, USA.
Kenneth C BilchickDivision of Cardiovascular Medicine, University of Virginia Health System, 1215 Lee St., PO Box 800158, Charlottesville, VA, 22908-0158, USA.
University of Virginia Health System · USUniversity of Alabama at Birmingham · USHeartland Regional Medical Center · USIllinois College · USIndiana University – Purdue University Indianapolis · USKarolinska Institutet · SEUniversity of Washington Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ventriculo-arterial (VA) coupling has been shown to have physiologic importance in heart failure (HF). We hypothesized that the systemic arterial pulsatility index (SAPi), a measure that integrates pulse pressure and a proxy for left ventricular end-diastolic pressure, would be associated with adverse outcomes in advanced HF. We evaluated the SAPi ([systemic systolic blood pressure-systemic diastolic blood pressure]/pulmonary artery wedge pressure) obtained from the final hemodynamic measurement in patients randomized to therapy guided by a pulmonary arterial catheter (PAC) and with complete data in the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial. Cox proportional hazards regression was performed for the outcomes of (a) death, transplant, left ventricular assist device (DTxLVAD) or hospitalization, (DTxLVADHF) and (b) DTxLVAD. Among 142 patients (mean age 56.8 ± 13.3 years, 30.3% female), the median SAPi was 2.57 (IQR 1.63-3.45). Increasing SAPi was associated with significant reductions in DTxLVAD (HR 0.60 per unit increase in SAPi, 95% CI 0.44-0.84) and DTxLVADHF (HR 0.81 per unit increase, 95% CI 0.70-0.95). Patients with a SAPi ≤ 2.57 had a marked increase in both outcomes, including more than twice the risk of DTxLVAD (HR 2.19, 95% CI 1.11-4.30) over 6 months. Among advanced heart failure patients with invasive hemodynamic monitoring in the ESCAPE trial, SAPi was strongly associated with adverse clinical outcomes. These findings support further investigation of the SAPi to guide treatment and prognosis in HF undergoing invasive hemodynamic monitoring.

Indexed as

Heart-Assist DevicesHeart FailureAdultAgedCatheterization, Swan-GanzFemaleHospitalizationHumansMaleMiddle AgedPulmonary Wedge PressureHeart failureHeart failure outcomesSAPiVentriculo–arterial coupling

Identifiers

PMID35534640
OpenAlexW4229445219

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.