Association Between Right Ventricular Contractile Function and Cardiac Events in Isolated Postcapillary and Combined Pre- and Postcapillary Pulmonary Hypertension

• Published in: Journal of cardiac failure 2020-01, Vol.26 (1), p.43-51
• Main Authors: Kusunose, Kenya, Yamada, Nao, Yamada, Hirotsugu, Nishio, Susumu, Saijo, Yoshihito, Hirata, Yukina, Torii, Yuta, Ise, Takayuki, Yamaguchi, Koji, Fukuda, Daiju, Yagi, Shusuke, Soeki, Takeshi, Wakatsuki, Tetsuzo, Sata, Masataka
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Capillaries - diagnostic imaging; Capillaries - physiopathology; Cardiac Catheterization - methods; Cohort Studies; combined pre- and postcapillary; Female; Follow-Up Studies; Humans; Hypertension, Pulmonary - diagnostic imaging; Hypertension, Pulmonary - physiopathology; isolated postcapillary; Male; Middle Aged; Myocardial Contraction - physiology; Prospective Studies; pulmonary arterial hypertension; Pulmonary hypertension; right ventricular function; Ventricular Function, Right - physiology
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2019.08.021

Recent studies have shown that patients with combined pre- and postcapillary pulmonary hypertension (CpcPH) had worse outcomes than those with isolated postcapillary pulmonary hypertension (IpcPH). However, the prognostic factors including right ventricular (RV) function have not been well documented. The aim of this study was to assess the differentiation of PH phenotypes, using echocardiography, and the association between RV longitudinal strain and cardiac events. We prospectively recruited consecutive patients who had undergone right heart catheterization. The primary endpoint was cardiovascular death or readmission due to heart failure. We included 137 patients with Group 2 PH. A RV longitudinal strain of 17% was sensitive (85%) and specific (70%) to determine the CpcPH. During a median period of 31 months, 43 patients experienced the primary endpoint during follow-up. In a multivariate analysis, RV longitudinal strain was associated with the primary endpoint in both CpcPH and IpcPH (HR: 0.84, P = 0.003; HR: 0.86, P = 0.001). Lower RV longitudinal strain was independently associated with worse outcomes in CpcPH and IpcPH. RV longitudinal strain may play a prognostic role in PH phenotypes.