Predictors and prognosis of right ventricular function in pulmonary hypertension due to heart failure with reduced ejection fraction

Aims Failure of right ventricular (RV) function worsens outcome in pulmonary hypertension (PH). The adaptation of RV contractility to afterload, the RV‐pulmonary artery (PA) coupling, is defined by the ratio of RV end‐systolic to PA elastances (Ees/Ea). Using pressure–volume loop (PV‐L) technique we...

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Bibliographic Details
Published in:ESC Heart Failure 2021-08, Vol.8 (4), p.2968-2981
Main Authors: Schmeißer, Alexander, Rauwolf, Thomas, Groscheck, Thomas, Fischbach, Katharina, Kropf, Siegfried, Luani, Blerim, Tanev, Ivan, Hansen, Michael, Meißler, Saskia, Schäfer, Kerstin, Steendijk, Paul, Braun‐Dullaeus, Ruediger C.
Format: Article
Language:English
Subjects:
Arterial elastance
Catheters
Ejection fraction
End‐systolic elastance
Heart failure
Heart Failure - complications
Heart Failure - diagnosis
Humans
Hypertension, Pulmonary - diagnosis
Hypertension, Pulmonary - etiology
Magnetic resonance imaging
Medical prognosis
Mortality
Original
Original s
Pressure–volume loops
Prognosis
Prospective Studies
Pulmonary hypertension
Regression analysis
Right ventricle‐pulmonary arterial coupling
RVEF, TAPSE, FAC, PA compliance
Software
Stroke Volume
Ventricular Dysfunction, Right - diagnosis
Ventricular Dysfunction, Right - etiology
Ventricular Function, Left
Ventricular Function, Right
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Summary:Aims Failure of right ventricular (RV) function worsens outcome in pulmonary hypertension (PH). The adaptation of RV contractility to afterload, the RV‐pulmonary artery (PA) coupling, is defined by the ratio of RV end‐systolic to PA elastances (Ees/Ea). Using pressure–volume loop (PV‐L) technique we aimed to identify an Ees/Ea cut‐off predictive for overall survival and to assess hemodynamic and morphologic conditions for adapted RV function in secondary PH due to heart failure with reduced ejection fraction (HFREF). Methods and results This post hoc analysis is based on 112 patients of the prospective Magdeburger Resynchronization Responder Trial. All patients underwent right and left heart echocardiography and a baseline PV‐L and RV catheter measurement. A subgroup of patients (n = 50) without a pre‐implanted cardiac device underwent magnetic resonance imaging at baseline. The analysis revealed that 0.68 is an optimal Ees/Ea cut‐off (area under the curve: 0.697, P 
ISSN:2055-5822
2055-5822
DOI:10.1002/ehf2.13386