Right Ventricular Function and Pulmonary Coupling in Patients With Heart Failure and Preserved Ejection Fraction

• Published in: Journal of the American College of Cardiology 2023-08, Vol.82 (6), p.489-499
• Main Authors: Inciardi, Riccardo M., Abanda, Martin, Shah, Amil M., Cikes, Maja, Claggett, Brian, Skali, Hicham, Vaduganathan, Muthiah, Prasad, Narayana, Litwin, Sheldon, Merkely, Bela, Kosztin, Annamaria, Nagy, Klaudia Vivien, Shah, Sanjiv J., Mullens, Wilfred, Zile, Michael R., Lam, Carolyn S.P., Pfeffer, Marc A., McMurray, John J.V., Solomon, Scott D.
• Format: Article
• Language: English
• Subjects: heart failure; pulmonary circulation; right ventricular; speckle-tracking
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2023.05.010

Limited data exist to characterize novel measures of right ventricular (RV) function and the coupling to pulmonary circulation in patients with heart failure and preserved left ventricular ejection fraction (HFpEF). This study sought to assess the clinical implications of RV function, the association with N-terminal pro–B-type natriuretic peptide, and the risk for adverse events among patients with HFpEF. This study analyzed measures of RV function by assessing absolute RV free wall longitudinal strain (RVFWLS) and its ratio to estimated pulmonary artery systolic pressure (PASP) (RVFWLS/PASP ratio) in 528 patients (mean age 74 ± 8 years, 56% female) with adequate echocardiographic images quality enrolled in the PARAGON-HF trial. Associations with baseline N-terminal pro–B-type natriuretic peptide and with total HF hospitalizations and cardiovascular death were assessed, after accounting for confounders. Overall, 311 patients (58%) had evidence of RV dysfunction, defined as absolute RVFWLS