ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Relationship between right atrial pressure and the Model for End-Stage Liver Disease (MELD) score in patients with advanced heart failure
Rezzan Deniz Acar1, Şencan Acar2, Mustafa Emre Gürcü3, Cem Doğan1, Zübeyde Bayram1, Samet Uysal1, Büşra Güvendi1, Özgür Yaşar Akbal1, Cihangir Kaymaz1, Mehmet Kaan Kırali4, Nihal Özdemir1
1Department of Cardiology, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
2Department of Internal Diseases, Division of Gastroenterology, Sakarya University Training and Research Hospital, Sakarya, Turkey
3Department of Anesthesiology and Reanimation, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
4Department of Cardiovascular Surgery, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2022.22254
Background: This study aims to investigate the association between right atrial pressure and the Model for End-Stage Liver Disease score and to evaluate the ability of this scoring system to accurately predict the value of right atrial pressure.

Methods: Between April 2016 and November 2018, a total of 137 patients (118 males, 19 females; median age: 49 years; range, 40 to 54 years) with advanced heart failure who were candidates for left ventricular assist device implantation or heart transplantation were retrospectively analyzed. We developed a formula calculated by using the biochemical and cardiac catheterization parameters of the patients.

Results: There was a strong correlation between the right atrial pressure and the scores (r=0.510, p<0.001). The estimated right atrial pressure was calculated as "2 + (0.92 ¥ Model for End-Stage Liver Disease Score)" (unstandardized coefficient 0.920, t value 7.674, p<0.001). The Model for End-Stage Liver Disease score was found to be an independent predictor of high right atrial pressure (odds ratio=1.491, 95% confidence interval: 1.244-1.786, p<0.001). The calculated area under the curve was 0.789 (95% confidence interval: 0.710-0.867, p<0.001) and the cut-off value of the Model for End-Stage Liver Disease score in the prediction of high right atrial pressure was 10.5 with 75% sensitivity and 73% specificity.

Conclusion: We define a method to calculate right atrial pressure obtained by using the Model for End-Stage Liver Disease score without the need for cardiac catheterization during the hospitalization and follow-up period of patients with advanced heart failure.

Keywords : Advanced heart failure, Model for End-Stage Liver Disease Score, right atrial pressure
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