Background: Residual clinical congestion is known to be associated with poor prognosis. However,
the prognostic importance of hemodynamic congestion remains uncertain. Methods: Among patients who were admitted with acute decompensated heart failure, 51 patients
underwent right heart catheterization (RHC) in clinically compensated status after
conventional treatment. We defined hemodynamic residual congestion as PCWP >15 mmHg
and investigated its prognostic importance. Results: During the mean follow up period of 437 ± 251 days, patients with relatively high
PCWP (>15 mmHg, n = 27) were more likely to have experienced major adverse cardiac
events (death, heart failure re-hospitalization, LVAD implantation) than those with
lower PCWP (<15 mmHg, n = 24, 51.9% versus 12.5%, Log-rank test, P = .01, Figure). Conclusion: Hemodynamic residual pulmonary congestion as assessed by RHC was associated with
poor prognosis in patients with heart failure even in clinically compensated status.
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