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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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| Published in: | ESC Heart Failure 2021-08, Vol.8 (4), p.2968-2981 |
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| creator | 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. |
| description | 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 |
| doi_str_mv | 10.1002/ehf2.13386 |
| format | article |
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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 < 0.001) predictive for overall survival (median follow up = 4.7 years, Ees/Ea ≥ 0.68 vs. <0.68, log‐rank 8.9, P = 0.003). In patients with PH (n = 76, 68%) multivariate Cox regression demonstrated the independent prognostic value of RV‐Ees/Ea in PH patients (hazard ratio 0.2, P < 0.038). Patients without PH (n = 36, 32%) and those with PH but RV‐Ees/Ea ≥ 0.68 showed comparable RV‐Ees/Ea ratios (0.88 vs. 0.9, P = 0.39), RV size/function, and survival. In contrast, secondary PH with RV‐PA coupling ratio Ees/Ea < 0.68 corresponded extremely close to cut‐off values that define RV dilatation/remodelling (RV end‐diastolic volume >160 mL, RV‐mass/volume‐ratio ≤0.37 g/mL) and dysfunction (right ventricular ejection fraction <38%, tricuspid annular plane systolic excursion <16 mm, fractional area change <42%, and stroke‐volume/end‐systolic volume ratio <0.59) and is associated with a dramatically increased short and medium‐term all‐cause mortality. Independent predictors of prognostically unfavourable RV‐PA coupling (Ees/Ea < 0.68) in secondary PH were a pre‐existent dilated RV [end‐diastolic volume >171 mL, odds ratio (OR) 0.96, P = 0.021], high pulsatile load (PA compliance <2.3 mL/mmHg, OR 8.6, P = 0.003), and advanced systolic left heart failure (left ventricular ejection fraction <30%, OR 1.23, P = 0.028).
Conclusions
The RV‐PA coupling ratio Ees/Ea predicts overall survival in PH due to HFREF and is mainly affected by pulsatile load, RV remodelling, and left ventricular dysfunction. Prognostically favourable coupling (RV‐Ees/Ea ≥ 0.68) in PH was associated with preserved RV size/function and mid‐term survival, comparable with HFREF without PH.]]></description><identifier>ISSN: 2055-5822</identifier><identifier>EISSN: 2055-5822</identifier><identifier>DOI: 10.1002/ehf2.13386</identifier><identifier>PMID: 33934536</identifier><language>eng</language><publisher>England: John Wiley & Sons, Inc</publisher><subject>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</subject><ispartof>ESC Heart Failure, 2021-08, Vol.8 (4), p.2968-2981</ispartof><rights>2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.</rights><rights>2021. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5816-8acde1a2867c05b36a29f2ee3655a62a083c58e12ed3dbe9bbf77006d445673d3</citedby><cites>FETCH-LOGICAL-c5816-8acde1a2867c05b36a29f2ee3655a62a083c58e12ed3dbe9bbf77006d445673d3</cites><orcidid>0000-0001-5542-8539</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2555674323/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2555674323?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,883,11545,25736,27907,27908,36995,36996,44573,46035,46459,53774,53776,74877</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33934536$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schmeißer, Alexander</creatorcontrib><creatorcontrib>Rauwolf, Thomas</creatorcontrib><creatorcontrib>Groscheck, Thomas</creatorcontrib><creatorcontrib>Fischbach, Katharina</creatorcontrib><creatorcontrib>Kropf, Siegfried</creatorcontrib><creatorcontrib>Luani, Blerim</creatorcontrib><creatorcontrib>Tanev, Ivan</creatorcontrib><creatorcontrib>Hansen, Michael</creatorcontrib><creatorcontrib>Meißler, Saskia</creatorcontrib><creatorcontrib>Schäfer, Kerstin</creatorcontrib><creatorcontrib>Steendijk, Paul</creatorcontrib><creatorcontrib>Braun‐Dullaeus, Ruediger C.</creatorcontrib><title>Predictors and prognosis of right ventricular function in pulmonary hypertension due to heart failure with reduced ejection fraction</title><title>ESC Heart Failure</title><addtitle>ESC Heart Fail</addtitle><description><![CDATA[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 < 0.001) predictive for overall survival (median follow up = 4.7 years, Ees/Ea ≥ 0.68 vs. <0.68, log‐rank 8.9, P = 0.003). In patients with PH (n = 76, 68%) multivariate Cox regression demonstrated the independent prognostic value of RV‐Ees/Ea in PH patients (hazard ratio 0.2, P < 0.038). Patients without PH (n = 36, 32%) and those with PH but RV‐Ees/Ea ≥ 0.68 showed comparable RV‐Ees/Ea ratios (0.88 vs. 0.9, P = 0.39), RV size/function, and survival. In contrast, secondary PH with RV‐PA coupling ratio Ees/Ea < 0.68 corresponded extremely close to cut‐off values that define RV dilatation/remodelling (RV end‐diastolic volume >160 mL, RV‐mass/volume‐ratio ≤0.37 g/mL) and dysfunction (right ventricular ejection fraction <38%, tricuspid annular plane systolic excursion <16 mm, fractional area change <42%, and stroke‐volume/end‐systolic volume ratio <0.59) and is associated with a dramatically increased short and medium‐term all‐cause mortality. Independent predictors of prognostically unfavourable RV‐PA coupling (Ees/Ea < 0.68) in secondary PH were a pre‐existent dilated RV [end‐diastolic volume >171 mL, odds ratio (OR) 0.96, P = 0.021], high pulsatile load (PA compliance <2.3 mL/mmHg, OR 8.6, P = 0.003), and advanced systolic left heart failure (left ventricular ejection fraction <30%, OR 1.23, P = 0.028).
Conclusions
The RV‐PA coupling ratio Ees/Ea predicts overall survival in PH due to HFREF and is mainly affected by pulsatile load, RV remodelling, and left ventricular dysfunction. Prognostically favourable coupling (RV‐Ees/Ea ≥ 0.68) in PH was associated with preserved RV size/function and mid‐term survival, comparable with HFREF without PH.]]></description><subject>Arterial elastance</subject><subject>Catheters</subject><subject>Ejection fraction</subject><subject>End‐systolic elastance</subject><subject>Heart failure</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - diagnosis</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - diagnosis</subject><subject>Hypertension, Pulmonary - etiology</subject><subject>Magnetic resonance imaging</subject><subject>Medical prognosis</subject><subject>Mortality</subject><subject>Original</subject><subject>Original s</subject><subject>Pressure–volume loops</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Pulmonary hypertension</subject><subject>Regression analysis</subject><subject>Right ventricle‐pulmonary arterial coupling</subject><subject>RVEF, TAPSE, FAC, PA compliance</subject><subject>Software</subject><subject>Stroke Volume</subject><subject>Ventricular Dysfunction, Right - diagnosis</subject><subject>Ventricular Dysfunction, Right - etiology</subject><subject>Ventricular Function, Left</subject><subject>Ventricular Function, Right</subject><issn>2055-5822</issn><issn>2055-5822</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp9kk1r3DAQhk1paUKaS39AEfRSCpvq2_alUELSBALpoT0LWRqvtXglV7IS9t4fXu06CUkPPWnQPDx6NUxVvSf4jGBMv8DQ0zPCWCNfVccUC7ESDaWvn9VH1WlKG4wxEZIIyt9WR4y1jAsmj6s_PyJYZ-YQE9LeoimGtQ_JJRR6FN16mNEd-Dk6k0cdUZ-9mV3wyHk05XEbvI47NOwmiDP4tO_YDGgOaAAdZ9RrN-YI6N7NAyovZQMWwQYWSR_1oXhXven1mOD04Typfl1e_Dy_Wt3cfr8-_3azMqIhctVoY4Fo2sjaYNExqWnbUwAmhdCSatywAgKhYJntoO26vq4xlpZzIWtm2Ul1vXht0Bs1Rbct6VXQTh0uQlyrEtqZERRra0ZEh43kgmtWa86gZhI6sI0kfV1cXxfXlLstWLMfkh5fSF92vBvUOtyphpGGc1kEnx4EMfzOkGa1dcnAOGoPISdFBSW85VK0Bf34D7oJOfoyqkKJ8jfOKCvU54UyMaQUoX8KQ7Da74ra74o67EqBPzyP_4Q-bkYByALcuxF2_1Gpi6tLukj_AloGy48</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>Schmeißer, Alexander</creator><creator>Rauwolf, Thomas</creator><creator>Groscheck, Thomas</creator><creator>Fischbach, Katharina</creator><creator>Kropf, Siegfried</creator><creator>Luani, Blerim</creator><creator>Tanev, Ivan</creator><creator>Hansen, Michael</creator><creator>Meißler, Saskia</creator><creator>Schäfer, Kerstin</creator><creator>Steendijk, Paul</creator><creator>Braun‐Dullaeus, Ruediger C.</creator><general>John Wiley & Sons, Inc</general><general>John Wiley and Sons Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0001-5542-8539</orcidid></search><sort><creationdate>202108</creationdate><title>Predictors and prognosis of right ventricular function in pulmonary hypertension due to heart failure with reduced ejection fraction</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5816-8acde1a2867c05b36a29f2ee3655a62a083c58e12ed3dbe9bbf77006d445673d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Arterial elastance</topic><topic>Catheters</topic><topic>Ejection fraction</topic><topic>End‐systolic elastance</topic><topic>Heart failure</topic><topic>Heart Failure - complications</topic><topic>Heart Failure - diagnosis</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - diagnosis</topic><topic>Hypertension, Pulmonary - etiology</topic><topic>Magnetic resonance imaging</topic><topic>Medical prognosis</topic><topic>Mortality</topic><topic>Original</topic><topic>Original s</topic><topic>Pressure–volume loops</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Pulmonary hypertension</topic><topic>Regression analysis</topic><topic>Right ventricle‐pulmonary arterial coupling</topic><topic>RVEF, TAPSE, FAC, PA compliance</topic><topic>Software</topic><topic>Stroke Volume</topic><topic>Ventricular Dysfunction, Right - diagnosis</topic><topic>Ventricular Dysfunction, Right - etiology</topic><topic>Ventricular Function, Left</topic><topic>Ventricular Function, Right</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schmeißer, Alexander</creatorcontrib><creatorcontrib>Rauwolf, Thomas</creatorcontrib><creatorcontrib>Groscheck, Thomas</creatorcontrib><creatorcontrib>Fischbach, Katharina</creatorcontrib><creatorcontrib>Kropf, Siegfried</creatorcontrib><creatorcontrib>Luani, Blerim</creatorcontrib><creatorcontrib>Tanev, Ivan</creatorcontrib><creatorcontrib>Hansen, Michael</creatorcontrib><creatorcontrib>Meißler, Saskia</creatorcontrib><creatorcontrib>Schäfer, Kerstin</creatorcontrib><creatorcontrib>Steendijk, Paul</creatorcontrib><creatorcontrib>Braun‐Dullaeus, Ruediger C.</creatorcontrib><collection>Wiley Online Library</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>ESC Heart Failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schmeißer, Alexander</au><au>Rauwolf, Thomas</au><au>Groscheck, Thomas</au><au>Fischbach, Katharina</au><au>Kropf, Siegfried</au><au>Luani, Blerim</au><au>Tanev, Ivan</au><au>Hansen, Michael</au><au>Meißler, Saskia</au><au>Schäfer, Kerstin</au><au>Steendijk, Paul</au><au>Braun‐Dullaeus, Ruediger C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors and prognosis of right ventricular function in pulmonary hypertension due to heart failure with reduced ejection fraction</atitle><jtitle>ESC Heart Failure</jtitle><addtitle>ESC Heart Fail</addtitle><date>2021-08</date><risdate>2021</risdate><volume>8</volume><issue>4</issue><spage>2968</spage><epage>2981</epage><pages>2968-2981</pages><issn>2055-5822</issn><eissn>2055-5822</eissn><abstract><![CDATA[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 < 0.001) predictive for overall survival (median follow up = 4.7 years, Ees/Ea ≥ 0.68 vs. <0.68, log‐rank 8.9, P = 0.003). In patients with PH (n = 76, 68%) multivariate Cox regression demonstrated the independent prognostic value of RV‐Ees/Ea in PH patients (hazard ratio 0.2, P < 0.038). Patients without PH (n = 36, 32%) and those with PH but RV‐Ees/Ea ≥ 0.68 showed comparable RV‐Ees/Ea ratios (0.88 vs. 0.9, P = 0.39), RV size/function, and survival. In contrast, secondary PH with RV‐PA coupling ratio Ees/Ea < 0.68 corresponded extremely close to cut‐off values that define RV dilatation/remodelling (RV end‐diastolic volume >160 mL, RV‐mass/volume‐ratio ≤0.37 g/mL) and dysfunction (right ventricular ejection fraction <38%, tricuspid annular plane systolic excursion <16 mm, fractional area change <42%, and stroke‐volume/end‐systolic volume ratio <0.59) and is associated with a dramatically increased short and medium‐term all‐cause mortality. Independent predictors of prognostically unfavourable RV‐PA coupling (Ees/Ea < 0.68) in secondary PH were a pre‐existent dilated RV [end‐diastolic volume >171 mL, odds ratio (OR) 0.96, P = 0.021], high pulsatile load (PA compliance <2.3 mL/mmHg, OR 8.6, P = 0.003), and advanced systolic left heart failure (left ventricular ejection fraction <30%, OR 1.23, P = 0.028).
Conclusions
The RV‐PA coupling ratio Ees/Ea predicts overall survival in PH due to HFREF and is mainly affected by pulsatile load, RV remodelling, and left ventricular dysfunction. Prognostically favourable coupling (RV‐Ees/Ea ≥ 0.68) in PH was associated with preserved RV size/function and mid‐term survival, comparable with HFREF without PH.]]></abstract><cop>England</cop><pub>John Wiley & Sons, Inc</pub><pmid>33934536</pmid><doi>10.1002/ehf2.13386</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0001-5542-8539</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | ESC Heart Failure, 2021-08, Vol.8 (4), p.2968-2981 |
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| language | eng |
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| source | Wiley Online Library; Publicly Available Content Database; PubMed Central |
| 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 |
| title | Predictors and prognosis of right ventricular function in pulmonary hypertension due to heart failure with reduced ejection fraction |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-16T21%3A57%3A37IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_doaj_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Predictors%20and%20prognosis%20of%20right%20ventricular%20function%20in%20pulmonary%20hypertension%20due%20to%20heart%20failure%20with%20reduced%20ejection%20fraction&rft.jtitle=ESC%20Heart%20Failure&rft.au=Schmei%C3%9Fer,%20Alexander&rft.date=2021-08&rft.volume=8&rft.issue=4&rft.spage=2968&rft.epage=2981&rft.pages=2968-2981&rft.issn=2055-5822&rft.eissn=2055-5822&rft_id=info:doi/10.1002/ehf2.13386&rft_dat=%3Cproquest_doaj_%3E2555674323%3C/proquest_doaj_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c5816-8acde1a2867c05b36a29f2ee3655a62a083c58e12ed3dbe9bbf77006d445673d3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2555674323&rft_id=info:pmid/33934536&rfr_iscdi=true |