Abstract 17675: Long-Term Prognostic Implications of Jugular Venous Distension Among Patients Hospitalized With Acute Heart Failure
Background: Jugular venous distension (JVD) is a simple clinical marker of heart failure (HF) severity, yet data regarding the prognostic implications of this finding in the ’real-life’ setting are limited and conflicting.
Methods: The independent association between JVD and 4-year mortality was assessed among 2,212 patients hospitalized with acute de novo HF who were enrolled in the Heart Failure Survey in ISrael (HFSIS 2003) survey, The presence of JVD was ascertained by physical examination on admission. The endpoint of this study was 4-year all-cause mortality compared in patients with and without JVD.
Results: Independent predictors of JVD among study patients included, the presence of hyponatremia (OR 1.48; p 0.03), reduced LV function (OR 1.24; p 0.03), anemia (OR 1.3; p 0.01), higher NYHA functional class (OR 1.34; p<0.01) and age > 75 years (OR 1.32; p 0.01).At 4-years of follow-up, the cumulative probability of all-cause mortality following hospitalization with acute HF was significantly higher among patients with vs. without JVD (72.3% vs. 60.5%; respectively p<0.001 [Figure 1]). Consistently, multivariate analysis demonstrated that JVD is independently associated with increased risk of all-cause 4-year mortality (HR 1.14; confidence interval (CI) 95%; 1.03-1.27, p 0.02), after further adjustment for clinical and echocardiographic measures.
Conclusions: In patients admitted with HF, JVD is associated with specific risk factors, and is independently associated with increased risk of all-cause long-term mortality. These findings can be used for improved risk assessment in this high-risk population.
- © 2013 by American Heart Association, Inc.