Clinical and Prognostic Significance of Positive Hepatojugular Reflux on Discharge in Acute Heart Failure: Insights from the ESCAPE Trial
Table 1
Demographic, clinical, laboratory, hemodynamic, and echocardiographic characteristics of patients with or without hepatojugular reflux on discharge enrolled in the ESCAPE trial.
+ve HJR on discharge ()
−ve HJR on discharge ()
value
Baseline demographics
Age (years, m ± SD)
59.3 ± 13.6
54.7 ± 13.8
0.003
Male sex % ()
71.3% (82/115)
74.7% (207/277)
0.483
White race % ()
60.9% (70/115)
59.9% (166/277)
0.862
BMI on admission (Kg/m2, m ± SD)
27.9 ± 6.4
29.1 ± 6.9
0.119
BMI on discharge (Kg/m2, m ± SD)
26.8 ± 6
27.9 ± 6.9
0.199
Comorbidities
Ischemic heart disease % ()
63.7% (72/113)
49.5% (137/277)
0.011
Atrial fibrillation % ()
36.3% (41/113)
26.7% (74/277)
0.061
CABG % ()
34.5% (39/113)
27.1% (75/277)
0.144
Stroke % ()
8% (9/113)
9.7% (27/277)
0.582
Hypertension % ()
49.6% (56/113)
45.1% (125/277)
0.426
Hepatic disease % ()
10.6% (12/113)
7.6% (21/277)
0.330
DM on oral medication % ()
16.8% (19/113)
17% (47/277)
0.971
COPD % ()
19.5% (22/113)
15.5% (43/277)
0.344
PVD % ()
20.4% (23/113)
9% (25/277)
0.003
Mitral regurgitation % ()
11.5% (13/113)
10.1% (28/277)
0.684
Tricuspid regurgitation % ()
8% (9/113)
2.5% (7/277)
0.02
NYHA class IV at baseline % ()
92% (104/113)
83.4% (231/277)
0.034
Clinical and hemodynamic variables on discharge
Supine SBP (mmHg, m ± SD)
102.5 ± 15.4
101.2 ± 14.3
0.413
Supine DBP (mmHg, m ± SD)
61.5 ± 10.8
61.3 ± 10.9
0.925
Supine heart rate (bpm, m ± SD)
79.7 ± 14.3
79.5 ± 13.9
0.918
Respiratory rate (breath/min, m ± SD)
18.6 ± 3.4
18.6 ± 2.4
0.234
6-Minute walk distance (feet, m ± SD)
823 ± 403
794 ± 356
0.734
NYHA class IV at discharge % ()
23.9% (27/113)
14.2% (39/274)
0.023
Laboratory variables on discharge
BUN (mg/dL, m ± SD)
42.2 ± 25
35.3 ± 19.7
0.019
Creatinine (mg/dL, m ± SD)
1.6 ± 0.7
1.5 ± 0.8
0.068
Total bilirubin (mg/dL, m ± SD)
0.83 ± 0.48
0.85 ± 0.48
0.809
Direct bilirubin (mg/dL, m ± SD)
0.39 ± 0.37
0.36 ± 0.32
0.996
AST (U/L, m ± SD)
39.7 ± 51.1
34.5 ± 23
0.661
ALT (U/L, m ± SD)
43.7 ± 101.6
33.7 ± 32.7
0.701
Na (meq/L, m ± SD)
135 ± 5.1
135.4 ± 4
0.758
Hematocrit (%, m ± SD)
36.9 ± 5.8
42.4 ± 40.9
0.026
Troponin I (ng/mL, m ± SD)
0.03 ± 0.02
0.15 ± 0.39
0.753
Echocardiographic data on discharge
TR velocity (m ± SD)
3.1 ± 0.5
2.9 ± 0.5
0.04
EF (m ± SD)
22.4 ± 10
20.2 ± 8.2
0.189
RA area (m ± SD)
27 ± 8.3
25.1 ± 8.2
0.142
RV area in systole (m ± SD)
19.6 ± 7
18.3 ± 7.2
0.236
RV area in diastole (m ± SD)
25.8 ± 7.4
24.4 ± 7.6
0.251
E/A ratio (m ± SD)
2.68 ± 1.46
2.66 ± 4.83
0.009
Deceleration of velocity (m ± SD)
135 ± 33
157 ± 69
0.261
BMI: body mass index; CABG: coronary artery bypass graft; DM: diabetes mellitus; COPD: chronic obstructive pulmonary disease; PVD: peripheral vascular disease; NYHA: New York Heart Association; SBP: systolic blood pressure; DBP: diastolic blood pressure; BUN: blood urea nitrogen; EF: ejection fraction; RV: right ventricle.
