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

Abstract

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.

Tricuspid Regurgitation Peak Gradient (TRPG)/Tricuspid Annulus Plane Systolic Excursion (TAPSE) ― A Novel Parameter for Stepwise Echocardiographic Risk Stratification in Normotensive Patients With Acute Pulmonary Embolism ―

“…17 In a group of 1,663 patients with heart failure, Ghio et al demonstrated that TAPSE/PASP was a powerful predictor of prognosis. 18 Other studies have confirmed the prognostic significance of TAPSE/PASP parameter in patients with heart failure. 19,20 TAPSE is a well-known, quick, and easily measurable echocardiographic parameter that does not require sophis- Table 2.…”

Prognostic Value of Right Ventricular Dysfunction in Heart Failure With Reduced Ejection Fraction

“…RV failure is a detrimental condition that is associated with significant morbidity and mortality, not only in patients with HFrEF but also in HF with preserved EF 3,26 and other cardiac diseases. 11,12 Recognition of the prognostic importance of RV function has recently stimulated the development of imaging techniques capable of reliably assessing RV function.…”

“…Measurement of tricuspid annular plane systolic excursion (TAPSE) by M-mode echocardiography has long been considered as the simplest, yet the most reliable, indicator of RV dysfunction. Importantly, impaired RV function by TAPSE measurement is common in patients with HFrEF, being found in 35% to 50% of cases, 1,2,4,5 in whom it represents an independent marker of poor prognosis, either when used alone 1,[3][4][5] or combined with pulmonary artery systolic pressure, as an indicator of RV-to-pulmonary circulation coupling. 2 Recently, 2-dimensional (2D) strain imaging technique, such as speckle-tracking echocardiography (STE), has allowed cardiologists to investigate myocardial mechanics easily and with greater accuracy, being relatively angle independent.…”

Baseline diastolic pressure gradient and pressure reduction in chronic heart failure patients implanted with the CardioMEMS™ HF sensor

“…Isolated post‐capillary PH (Ipc‐PH) represents a unique subset of those with PH and can be defined by a diastolic pulmonary gradient (DPG) <7 mmHg, while combined pre‐capillary and post‐capillary PH (Cpc‐PH) patients have a DPG ≥7 mmHg 3. More importantly, Cpc‐PH patients not only develop maladaptive pulmonary vascular remodelling but also have poorer right ventricular–pulmonary vascular coupling and worse clinical outcomes 1, 5, 7, 8, 9, 10…”