Does the Modified Glasgow Prognostic Score be a Predictive Parameter for Right Ventricular Systolic Dysfunction in Patients with Acute Decompensated Heart Failure?

Abstract

Objectives: Right ventricular sistolic dysfunction (RHF) is associated with a poor prognosis in paients with acute de- compensated heart failure (ADHF), regardless of the degree of left ventricular (LV) dysfunction. As previously shown, cachexia in heart failure is associated with right ventricular (RV) dysfunction rather than LV impairment. Modified Glasgow prognostic score (mGPS), which is calculated based on serum albumin (SA) and C-reactive protein (CRP) levels, is associated with inflammatory and nutritional status. Aims of this study was to investigate the relationship between mGPS and RV functions in patients with ADHF. Methods: We prospectively enrolled 122 ADHF consecutive patients with reduced LV ejection fraction (LVEF <%35). RHF was determined according to RV fractional area change (RV FAC). Patients with RVFAC <35 % were considered as biventricular heart failure (BHF) and those with RVFAC ≥35% were considered as isolated left heart failure (isolated- LHF). mGPS was scored as 0, 1 or 2 according to CRP and SA levels. Results: Compared to isolated-LHF patients, mGPS, B-type natriuretic peptide (BNP), CRP, systolic pulmonary artery pressure (SPAP), mitral E/Em were higher, while SA, hemoglobin, tricuspid annular plane systolic excursion (TAPSE) and RVFAC were lower in BHF patients (p<0.05). Correlation analysis showed a significantly correlation of mGPS with RHF (r=-0.424, p<0.001). Logistic analysis showed mGPS [OR:1.098 (1.027-1.179), p=0.012] was an independent predictive factor for RHF. Conclusion: mGPS is an important independent predictor of RV dysfunction in patients with ADHF.