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, on behalf of all investigators

Research output: Contribution to journalArticle

51 Citations (Scopus)

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 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. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology
Original languageEnglish
Pages (from-to)873-879
Number of pages7
JournalEuropean Journal of Heart Failure
Volume19
Issue number7
DOIs
Publication statusPublished - 2017

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Right Ventricular Dysfunction
Heart Failure
Stroke Volume
Cardiomyopathies
Heart Diseases

Keywords

  • Echocardiography
  • Heart failure
  • Pulmonary hypertension
  • Right ventricle
  • adult
  • aged
  • Article
  • cardiomyopathy
  • cause of death
  • cohort analysis
  • controlled study
  • diagnostic test accuracy study
  • echocardiography
  • female
  • heart failure with preserved ejection fraction
  • heart failure with reduced ejection fraction
  • heart left ventricle ejection fraction
  • heart rate
  • heart right ventricle failure
  • heart right ventricle function
  • human
  • hypertension
  • ischemic heart disease
  • major clinical study
  • male
  • priority journal
  • prognosis
  • pulmonary artery
  • receiver operating characteristic
  • retrospective study
  • sinus rhythm
  • survival analysis
  • systolic blood pressure

Cite this

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, on behalf of all.

In: European Journal of Heart Failure, Vol. 19, No. 7, 2017, p. 873-879.

Research output: Contribution to journalArticle

@article{73f69d953c044eadb183fb94f1ec9299,
title = "Different correlates but similar prognostic implications for right ventricular dysfunction in heart failure patients with reduced or preserved ejection fraction",
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 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. {\circledC} 2016 The Authors. European Journal of Heart Failure {\circledC} 2016 European Society of Cardiology",
keywords = "Echocardiography, Heart failure, Pulmonary hypertension, Right ventricle, adult, aged, Article, cardiomyopathy, cause of death, cohort analysis, controlled study, diagnostic test accuracy study, echocardiography, female, heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, heart left ventricle ejection fraction, heart rate, heart right ventricle failure, heart right ventricle function, human, hypertension, ischemic heart disease, major clinical study, male, priority journal, prognosis, pulmonary artery, receiver operating characteristic, retrospective study, sinus rhythm, survival analysis, systolic blood pressure",
author = "S. Ghio and M. Guazzi and A.B. Scardovi and C. Klersy and F. Clemenza and E. Carluccio and P.L. Temporelli and A. Rossi and P. Faggiano and E. Traversi and O. Vriz and F.L. Dini and investigators, {on behalf of all}",
note = "Cited By :8 Export Date: 2 March 2018 CODEN: EJHFF Correspondence Address: Ghio, S.; Division of Cardiology, Fondazione IRCCS, Policlinico San Matteo, Piazza Golgi 1, Italy; email: s.ghio@smatteo.pv.it References: Di Salvo, T.G., Mathier, M., Semigran, M.J., Dec, G.W., Preserved right ventricular ejection fraction predicts exercise capacity and survival in advanced heart failure (1995) J Am Coll Cardiol, 25, pp. 1143-1153; de Groote, P., Millaire, A., Foucher-Hossein, C., Nugue, O., Marchandise, X., Ducloux, G., Lablanche, J.M., Right ventricular ejection fraction is an independent predictor of survival in patients with moderate heart failure (1998) J Am Coll Cardiol, 32, pp. 948-954; Ghio, S., Recusani, F., Klersy, C., Sebastiani, R., Laudisa, M.L., Campana, C., Gavazzi, A., Tavazzi, L., Prognostic usefulness of the tricuspid annular plane systolic excursion in patients with congestive heart failure secondary to idiopathic or ischemic dilated cardiomyopathy (2000) Am J Cardiol, 85, pp. 837-842; Ghio, S., Gavazzi, A., Campana, C., Inserra, C., Klersy, C., Sebastiani, R., Arbustini, E., Tavazzi, L., Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure (2001) J Am Coll Cardiol, 37, pp. 183-188; Meyer, P., Filippatos, G.S., Ahmed, M.I., Iskandrian, A.E., Bittner, V., Perry, G.J., White, M., Ahmed, A., Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure (2010) Circulation, 121, pp. 252-258; Kjaergaard, J., Akkan, D., Iversen, K.K., Kober, L., Torp-Pedersen, C., Hassager, C., Right ventricular dysfunction as an independent predictor of short- and long-term mortality in patients with heart failure (2007) Eur J Heart Fail, 9, pp. 610-616; Guazzi, M., Bandera, F., Pelissero, G., Castelvecchio, S., Menicanti, L., Ghio, S., Temporelli, P.L., Arena, R., Tricuspid annular plane systolic excursion and pulmonary arterial systolic pressure relationship in heart failure: an index of right ventricular contractile function and prognosis (2013) Am J Physiol Heart Circ Physiol, 305, pp. H1373-H1381; Ghio, S., Temporelli, P.L., Klersy, C., Simioniuc, A., Girardi, B., Scelsi, L., Rossi, A., Dini, F.L., Prognostic relevance of a non-invasive evaluation of right ventricular function and pulmonary artery pressure in patients with chronic heart failure (2013) Eur J Heart Fail, 15, pp. 408-414; Mohammed, S.F., Hussain, I., AbouEzzeddine, O.F., Takahama, H., Kwon, S.H., Forfia, P., Roger, V.L., Redfield, M.M., Right ventricular function in heart failure with preserved ejection fraction: a community-based study (2014) Circulation, 130, pp. 2310-2320; Burke, M.A., Katz, D.H., Beussink, L., Selvaraj, S., Gupta, D.K., Fox, J., Chakrabarti, S., Shah, S.J., Prognostic importance of pathophysiologic markers in patients with heart failure and preserved ejection fraction (2014) Circ Heart Fail, 7, pp. 288-299; Melenovsky, V., Hwang, S.J., Lin, G., Redfield, M.M., Borlaug, B.A., Right heart dysfunction in heart failure with preserved ejection fraction (2014) Eur Heart J, 35, pp. 3452-3462; Aschauer, S., Kammerlander, A.A., Zotter-Tufaro, C., Ristl, R., Pfaffenberger, S., Bachmann, A., Duca, F., Mascherbauer, J., The right heart in heart failure with preserved ejection fraction: insights from cardiac magnetic resonance imaging and invasive haemodynamics (2016) Eur J Heart Fail, 18, pp. 71-80; Vachi{\'e}ry, J.L., Adir, Y., Barber{\`a}, J.A., Champion, H., Coghlan, J.G., Cottin, V., De Marco, T., Seeger, W., Pulmonary hypertension due to left heart diseases (2013) J Am Coll Cardiol, 62 (25), pp. D100-D108; Frea, S., Pidello, S., Bovolo, V., Iacovino, C., Franco, E., Pinneri, F., Galluzzo, A., Gaita, F., Prognostic incremental role of right ventricular function in acute decompensation of advanced chronic heart failure (2016) Eur J Heart Fail, 18, pp. 564-572; McKee, P.A., Castelli, W.P., McNamara, P.M., Kannel, W.B., The natural history of congestive heart failure: the Framingham study (1971) N Engl J Med, 285, pp. 1441-1446; Ponikowski, P., Voors, A.A., Anker, S.D., Bueno, H., Cleland, J.G., Coats, A.J., Falk, V., van der Meer, P., 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC (2016) Eur J Heart Fail, 18, pp. 891-975; Nagueh, S.F., Appleton, C.P., Gillebert, T.C., Marino, P.N., Oh, J.K., Smiseth, O.A., Waggoner, A.D., Evangelisa, A., Recommendations for the evaluation of left ventricular diastolic function by echocardiography (2009) Eur J Echocardiogr, 10, pp. 165-193; Haddad, F., Doyle, R., Murphy, D.J., Hunt, S.A., Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure (2008) Circulation, 117, pp. 1717-1731; Vatta, M., Stetson, S.J., Jimenez, S., Entman, M.L., Noon, G.P., Bowles, N.E., Towbin, J.A., Torre-Amione, G., Molecular normalization of dystrophin in the failing left and right ventricle of patients treated with either pulsatile or continuous flow-type ventricular assist devices (2004) J Am Coll Cardiol, 43, pp. 811-817; Damiano, R.J., Jr., La Follette, P., Jr., Cox, J.L., Lowe, J.E., Santamore, W.P., Significant left ventricular contribution to right ventricular systolic function (1991) Am J Physiol, 261, pp. H1514-H1524; Hoffman, D., Sisto, D., Frater, R.W., Nikolic, S.D., Left-to-right ventricular interaction with a noncontracting right ventricle (1994) J Thorac Cardiovasc Surg, 107, pp. 1496-1502; Lam, C.S., Roger, V.L., Rodeheffer, R.J., Borlaug, B.A., Enders, F.T., Redfield, M.M., Pulmonary hypertension in heart failure with preserved ejection fraction: a community-based study (2009) J Am Coll Cardiol, 53, pp. 1119-1126; Guazzi, M., Pulmonary hypertension in heart failure preserved ejection fraction: prevalence, pathophysiology, and clinical perspectives (2014) Circ Heart Fail, 7, pp. 367-377; Bazaz, R., Edelman, K., Gulyasy, B., Lopez-Candales, A., Evidence of robust coupling of atrioventricular mechanical function of the right side of the heart: insights from M-mode analysis of annular motion (2008) Echocardiography, 25, pp. 557-561; Ghio, S., Perlini, S., Palladini, G., Marsan, N.A., Faggiano, G., Vezzoli, M., Klersy, C., Tavazzi, L., Importance of the echocardiographic evaluation of right ventricular function in patients with AL amyloidosis (2007) Eur J Heart Fail, 9, pp. 808-813; Sunagawa, K., Maughan, W.L., Sagawa, K., Optimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle (1985) Circ Res, 56, pp. 586-595",
year = "2017",
doi = "10.1002/ejhf.664",
language = "English",
volume = "19",
pages = "873--879",
journal = "European Journal of Heart Failure",
issn = "1388-9842",
publisher = "John Wiley & Sons, Ltd",
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}

TY - JOUR

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, on behalf of all

N1 - Cited By :8 Export Date: 2 March 2018 CODEN: EJHFF Correspondence Address: Ghio, S.; Division of Cardiology, Fondazione IRCCS, Policlinico San Matteo, Piazza Golgi 1, Italy; email: s.ghio@smatteo.pv.it References: Di Salvo, T.G., Mathier, M., Semigran, M.J., Dec, G.W., Preserved right ventricular ejection fraction predicts exercise capacity and survival in advanced heart failure (1995) J Am Coll Cardiol, 25, pp. 1143-1153; de Groote, P., Millaire, A., Foucher-Hossein, C., Nugue, O., Marchandise, X., Ducloux, G., Lablanche, J.M., Right ventricular ejection fraction is an independent predictor of survival in patients with moderate heart failure (1998) J Am Coll Cardiol, 32, pp. 948-954; Ghio, S., Recusani, F., Klersy, C., Sebastiani, R., Laudisa, M.L., Campana, C., Gavazzi, A., Tavazzi, L., Prognostic usefulness of the tricuspid annular plane systolic excursion in patients with congestive heart failure secondary to idiopathic or ischemic dilated cardiomyopathy (2000) Am J Cardiol, 85, pp. 837-842; Ghio, S., Gavazzi, A., Campana, C., Inserra, C., Klersy, C., Sebastiani, R., Arbustini, E., Tavazzi, L., Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure (2001) J Am Coll Cardiol, 37, pp. 183-188; Meyer, P., Filippatos, G.S., Ahmed, M.I., Iskandrian, A.E., Bittner, V., Perry, G.J., White, M., Ahmed, A., Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure (2010) Circulation, 121, pp. 252-258; Kjaergaard, J., Akkan, D., Iversen, K.K., Kober, L., Torp-Pedersen, C., Hassager, C., Right ventricular dysfunction as an independent predictor of short- and long-term mortality in patients with heart failure (2007) Eur J Heart Fail, 9, pp. 610-616; Guazzi, M., Bandera, F., Pelissero, G., Castelvecchio, S., Menicanti, L., Ghio, S., Temporelli, P.L., Arena, R., Tricuspid annular plane systolic excursion and pulmonary arterial systolic pressure relationship in heart failure: an index of right ventricular contractile function and prognosis (2013) Am J Physiol Heart Circ Physiol, 305, pp. H1373-H1381; Ghio, S., Temporelli, P.L., Klersy, C., Simioniuc, A., Girardi, B., Scelsi, L., Rossi, A., Dini, F.L., Prognostic relevance of a non-invasive evaluation of right ventricular function and pulmonary artery pressure in patients with chronic heart failure (2013) Eur J Heart Fail, 15, pp. 408-414; Mohammed, S.F., Hussain, I., AbouEzzeddine, O.F., Takahama, H., Kwon, S.H., Forfia, P., Roger, V.L., Redfield, M.M., Right ventricular function in heart failure with preserved ejection fraction: a community-based study (2014) Circulation, 130, pp. 2310-2320; Burke, M.A., Katz, D.H., Beussink, L., Selvaraj, S., Gupta, D.K., Fox, J., Chakrabarti, S., Shah, S.J., Prognostic importance of pathophysiologic markers in patients with heart failure and preserved ejection fraction (2014) Circ Heart Fail, 7, pp. 288-299; Melenovsky, V., Hwang, S.J., Lin, G., Redfield, M.M., Borlaug, B.A., Right heart dysfunction in heart failure with preserved ejection fraction (2014) Eur Heart J, 35, pp. 3452-3462; Aschauer, S., Kammerlander, A.A., Zotter-Tufaro, C., Ristl, R., Pfaffenberger, S., Bachmann, A., Duca, F., Mascherbauer, J., The right heart in heart failure with preserved ejection fraction: insights from cardiac magnetic resonance imaging and invasive haemodynamics (2016) Eur J Heart Fail, 18, pp. 71-80; Vachiéry, J.L., Adir, Y., Barberà, J.A., Champion, H., Coghlan, J.G., Cottin, V., De Marco, T., Seeger, W., Pulmonary hypertension due to left heart diseases (2013) J Am Coll Cardiol, 62 (25), pp. D100-D108; Frea, S., Pidello, S., Bovolo, V., Iacovino, C., Franco, E., Pinneri, F., Galluzzo, A., Gaita, F., Prognostic incremental role of right ventricular function in acute decompensation of advanced chronic heart failure (2016) Eur J Heart Fail, 18, pp. 564-572; McKee, P.A., Castelli, W.P., McNamara, P.M., Kannel, W.B., The natural history of congestive heart failure: the Framingham study (1971) N Engl J Med, 285, pp. 1441-1446; Ponikowski, P., Voors, A.A., Anker, S.D., Bueno, H., Cleland, J.G., Coats, A.J., Falk, V., van der Meer, P., 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC (2016) Eur J Heart Fail, 18, pp. 891-975; Nagueh, S.F., Appleton, C.P., Gillebert, T.C., Marino, P.N., Oh, J.K., Smiseth, O.A., Waggoner, A.D., Evangelisa, A., Recommendations for the evaluation of left ventricular diastolic function by echocardiography (2009) Eur J Echocardiogr, 10, pp. 165-193; Haddad, F., Doyle, R., Murphy, D.J., Hunt, S.A., Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure (2008) Circulation, 117, pp. 1717-1731; Vatta, M., Stetson, S.J., Jimenez, S., Entman, M.L., Noon, G.P., Bowles, N.E., Towbin, J.A., Torre-Amione, G., Molecular normalization of dystrophin in the failing left and right ventricle of patients treated with either pulsatile or continuous flow-type ventricular assist devices (2004) J Am Coll Cardiol, 43, pp. 811-817; Damiano, R.J., Jr., La Follette, P., Jr., Cox, J.L., Lowe, J.E., Santamore, W.P., Significant left ventricular contribution to right ventricular systolic function (1991) Am J Physiol, 261, pp. H1514-H1524; Hoffman, D., Sisto, D., Frater, R.W., Nikolic, S.D., Left-to-right ventricular interaction with a noncontracting right ventricle (1994) J Thorac Cardiovasc Surg, 107, pp. 1496-1502; Lam, C.S., Roger, V.L., Rodeheffer, R.J., Borlaug, B.A., Enders, F.T., Redfield, M.M., Pulmonary hypertension in heart failure with preserved ejection fraction: a community-based study (2009) J Am Coll Cardiol, 53, pp. 1119-1126; Guazzi, M., Pulmonary hypertension in heart failure preserved ejection fraction: prevalence, pathophysiology, and clinical perspectives (2014) Circ Heart Fail, 7, pp. 367-377; Bazaz, R., Edelman, K., Gulyasy, B., Lopez-Candales, A., Evidence of robust coupling of atrioventricular mechanical function of the right side of the heart: insights from M-mode analysis of annular motion (2008) Echocardiography, 25, pp. 557-561; Ghio, S., Perlini, S., Palladini, G., Marsan, N.A., Faggiano, G., Vezzoli, M., Klersy, C., Tavazzi, L., Importance of the echocardiographic evaluation of right ventricular function in patients with AL amyloidosis (2007) Eur J Heart Fail, 9, pp. 808-813; Sunagawa, K., Maughan, W.L., Sagawa, K., Optimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle (1985) Circ Res, 56, pp. 586-595

PY - 2017

Y1 - 2017

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 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. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology

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 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. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology

KW - Echocardiography

KW - Heart failure

KW - Pulmonary hypertension

KW - Right ventricle

KW - adult

KW - aged

KW - Article

KW - cardiomyopathy

KW - cause of death

KW - cohort analysis

KW - controlled study

KW - diagnostic test accuracy study

KW - echocardiography

KW - female

KW - heart failure with preserved ejection fraction

KW - heart failure with reduced ejection fraction

KW - heart left ventricle ejection fraction

KW - heart rate

KW - heart right ventricle failure

KW - heart right ventricle function

KW - human

KW - hypertension

KW - ischemic heart disease

KW - major clinical study

KW - male

KW - priority journal

KW - prognosis

KW - pulmonary artery

KW - receiver operating characteristic

KW - retrospective study

KW - sinus rhythm

KW - survival analysis

KW - systolic blood pressure

U2 - 10.1002/ejhf.664

DO - 10.1002/ejhf.664

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 -