Different correlates but similar prognostic implications for right ventricular dysfunction in heart failure patients with reduced or preserved ejection fraction

S. Ghio, M. Guazzi, A. B. Scardovi, C. Klersy, F. Clemenza, E. Carluccio, P. L. Temporelli, A. Rossi, P. Faggiano, E. Traversi, O. Vriz, F. L. Dini, all investigators

Research output: Contribution to journalArticle

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Abstract

AIMS: To evaluate whether the clinical and echocardiographic correlates and the prognostic significance of right ventricular (RV) dysfunction are different in heart failure patients with reduced (HFrEF), mid-range (HFmrEF), or preserved (HFpEF) left ventricular ejection fraction. METHODS AND RESULTS: The study included 1663 patients with heart failure caused by ischaemic or hypertensive heart disease or by idiopathic cardiomyopathy. Left ventricular ejection fraction was /=50% in 384 patients (HFpEF). Imaging of the right ventricle was performed by echocardiography; RV function was defined on the basis of tricuspid annular plane systolic excursion (TAPSE) and its normalization for pulmonary artery systolic pressure (PASP). All-cause mortality was the endpoint of survival analysis. Non-sinus rhythm, high heart rate, ischaemic aetiology and E-wave deceleration time 40 mmHg was by far the strongest correlate of a reduced TAPSE in HFpEF and HFmrEF patients (interaction analysis, P = 0.0011). TAPSE/PASP proved to be a powerful predictor of prognosis in all patients. CONCLUSIONS: The correlates of RV dysfunction differ in HFrEF compared with HFpEF and HFmrEF patients. Regardless of the extent of LV dysfunction, the TAPSE/PASP ratio is a powerful independent predictor of prognosis in all heart failure patients.
Original languageEnglish
Pages (from-to)873-879
Number of pages7
JournalEuropean Journal of Heart Failure
Volume19
Issue number7
DOIs
Publication statusPublished - Jul 1 2017

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Right Ventricular Dysfunction
Heart Failure
Pulmonary Artery
Blood Pressure
Stroke Volume
Right Ventricular Function
Deceleration
Survival Analysis
Cardiomyopathies
Heart Ventricles
Echocardiography
Heart Diseases
Heart Rate
Mortality

Keywords

  • Echocardiography
  • Heart failure
  • Pulmonary hypertension
  • Right ventricle

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Different correlates but similar prognostic implications for right ventricular dysfunction in heart failure patients with reduced or preserved ejection fraction. / Ghio, S.; Guazzi, M.; Scardovi, A. B.; Klersy, C.; Clemenza, F.; Carluccio, E.; Temporelli, P. L.; Rossi, A.; Faggiano, P.; Traversi, E.; Vriz, O.; Dini, F. L.; investigators, all.

In: European Journal of Heart Failure, Vol. 19, No. 7, 01.07.2017, p. 873-879.

Research output: Contribution to journalArticle

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T1 - Different correlates but similar prognostic implications for right ventricular dysfunction in heart failure patients with reduced or preserved ejection fraction

AU - Ghio, S.

AU - Guazzi, M.

AU - Scardovi, A. B.

AU - Klersy, C.

AU - Clemenza, F.

AU - Carluccio, E.

AU - Temporelli, P. L.

AU - Rossi, A.

AU - Faggiano, P.

AU - Traversi, E.

AU - Vriz, O.

AU - Dini, F. L.

AU - investigators, all

N1 - LR: 20170714; CI: (c) 2016 The Authors. European Journal of Heart Failure (c) 2016; JID: 100887595; OTO: NOTNLM; 2016/04/04 00:00 [received]; 2016/08/12 00:00 [revised]; 2016/08/29 00:00 [accepted]; 2016/11/20 06:00 [pubmed]; 2016/11/20 06:00 [medline]; 2016/11/19 06:00 [entrez]; ppublish

PY - 2017/7/1

Y1 - 2017/7/1

N2 - AIMS: To evaluate whether the clinical and echocardiographic correlates and the prognostic significance of right ventricular (RV) dysfunction are different in heart failure patients with reduced (HFrEF), mid-range (HFmrEF), or preserved (HFpEF) left ventricular ejection fraction. METHODS AND RESULTS: The study included 1663 patients with heart failure caused by ischaemic or hypertensive heart disease or by idiopathic cardiomyopathy. Left ventricular ejection fraction was /=50% in 384 patients (HFpEF). Imaging of the right ventricle was performed by echocardiography; RV function was defined on the basis of tricuspid annular plane systolic excursion (TAPSE) and its normalization for pulmonary artery systolic pressure (PASP). All-cause mortality was the endpoint of survival analysis. Non-sinus rhythm, high heart rate, ischaemic aetiology and E-wave deceleration time 40 mmHg was by far the strongest correlate of a reduced TAPSE in HFpEF and HFmrEF patients (interaction analysis, P = 0.0011). TAPSE/PASP proved to be a powerful predictor of prognosis in all patients. CONCLUSIONS: The correlates of RV dysfunction differ in HFrEF compared with HFpEF and HFmrEF patients. Regardless of the extent of LV dysfunction, the TAPSE/PASP ratio is a powerful independent predictor of prognosis in all heart failure patients.

AB - AIMS: To evaluate whether the clinical and echocardiographic correlates and the prognostic significance of right ventricular (RV) dysfunction are different in heart failure patients with reduced (HFrEF), mid-range (HFmrEF), or preserved (HFpEF) left ventricular ejection fraction. METHODS AND RESULTS: The study included 1663 patients with heart failure caused by ischaemic or hypertensive heart disease or by idiopathic cardiomyopathy. Left ventricular ejection fraction was /=50% in 384 patients (HFpEF). Imaging of the right ventricle was performed by echocardiography; RV function was defined on the basis of tricuspid annular plane systolic excursion (TAPSE) and its normalization for pulmonary artery systolic pressure (PASP). All-cause mortality was the endpoint of survival analysis. Non-sinus rhythm, high heart rate, ischaemic aetiology and E-wave deceleration time 40 mmHg was by far the strongest correlate of a reduced TAPSE in HFpEF and HFmrEF patients (interaction analysis, P = 0.0011). TAPSE/PASP proved to be a powerful predictor of prognosis in all patients. CONCLUSIONS: The correlates of RV dysfunction differ in HFrEF compared with HFpEF and HFmrEF patients. Regardless of the extent of LV dysfunction, the TAPSE/PASP ratio is a powerful independent predictor of prognosis in all heart failure patients.

KW - Echocardiography

KW - Heart failure

KW - Pulmonary hypertension

KW - Right ventricle

U2 - 10.1002/ejhf.664 [doi]

DO - 10.1002/ejhf.664 [doi]

M3 - Article

VL - 19

SP - 873

EP - 879

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1388-9842

IS - 7

ER -