Prognostic Role of RVGLS/PASP Ratio, a New Echocardiographic Parameter of the Right Ventricle-Pulmonary Artery Coupling, in Patients With Acute Heart Failure.

International journal of heart failure Pub Date : 2024-10-28 eCollection Date: 2024-10-01 DOI:10.36628/ijhf.2024.0048

Jae-Hyeong Park, Mijoo Kim, Jin Joo Park, Jun-Bean Park, Goo-Yeong Cho

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Abstract

Background and objectives: Few studies have addressed the predictive implications of right ventricular (RV) and pulmonary arterial (PA) coupling as assessed by echocardiography in patients with acute heart failure (AHF). This study aimed to ascertain the prognostic importance of RV-PA coupling in AHF cases and discern any divergence in its prognostic efficacy based on different heart failure (HF) phenotypes.

Methods: We evaluated RV-PA coupling by measuring the ratio of right ventricular global longitudinal strain (RVGLS) to pulmonary arterial systolic pressure (PASP), termed the RVGLS/PASP ratio, and assessed its prognostic role using the STrain for Risk Assessment and Therapeutic Strategies in Patients with Acute Heart Failure registry.

Results: From an AHF registry of 4312 patients, we analyzed the RVGLS/PASP ratio in 2,865 patients (1,449 men; age, 71.1±13.5 years). At a median follow-up of 35.0 months, 1,199 (41.8%) patients died. Remarkably, PASP (hazard ratio [HR], 1.012; p<0.001), RVGLS (HR, 1.019; p<0.001), and the RVGLS/PASP ratio (HR, 2.426; p<0.001) were statistically significant predictors of all-cause mortality in the univariate analysis. The RVGLS/PASP ratio was a significant predictor of all-cause mortality in all the HF phenotypes, including HF with reduced ejection fraction (HR, 2.124; p=0.002), HF with mildly reduced ejection fraction (HR, 2.733; p=0.021), and HF with preserved ejection fraction (HR, 2.134; p=0.006). Multivariate analysis after adjusting for clinical and echocardiographic variables revealed that the RVGLS/PASP ratio ≤0.32 was associated with a 36% increase in all-cause mortality (HR, 1.365; p<0.001).

Conclusions: Impaired RV-PA coupling, defined as an RVGLS/PASP ratio (≤0.32) was associated with an increased risk of mortality in patients with AHF across all HF phenotypes.

Trial registration: ClinicalTrials.gov Identifier: NCT03513653.

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右心室-肺动脉耦合的新超声心动图参数 RVGLS/PASP 比值对急性心力衰竭患者的预后作用

背景和目的：通过超声心动图评估急性心力衰竭（AHF）患者右心室（RV）和肺动脉（PA）耦合的预测意义，但很少有研究涉及。本研究旨在确定急性心力衰竭病例中 RV-PA 耦合对预后的重要性，并根据不同的心力衰竭（HF）表型鉴别其预后效果的差异：我们通过测量右心室整体纵向应变（RVGLS）与肺动脉收缩压（PASP）的比值（称为RVGLS/PASP比值）来评估RV-PA耦联，并利用急性心力衰竭患者风险评估和治疗策略的应变登记来评估其预后作用：我们从 4312 名急性心力衰竭患者的登记资料中分析了 2865 名患者（1449 名男性；年龄为 71.1±13.5 岁）的 RVGLS/PASP 比值。在中位 35.0 个月的随访中，1199 名患者（41.8%）死亡。值得注意的是，PASP（危险比 [HR]，1.012；P结论：RV-PA耦合受损（定义为RVGLS/PASP比值≤0.32）与所有HF表型的AHF患者死亡风险增加有关：试验注册：ClinicalTrials.gov Identifier：试验注册：ClinicalTrials.gov Identifier：NCT03513653。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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International journal of heart failure

CiteScore

6.30

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0.00%

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