Right ventricular recovery during follow‐up is associated with improved survival in patients with chronic heart failure with reduced ejection fraction

Abstract

Patients with chronic HFrEF who have abnormal TAPSE at baseline but reverse their dysfunction during follow-up have better survival than patients with either worsened TAPSE or persistently abnormal TAPSE, and similar to that of patients with persistently normal TAPSE.

December 2016 at a glance: cardiac metabolism, myocarditis, right ventricular function and prognostic markers

“…Right ventricular (RV) function was assessed by tricuspid annular plane systolic excursion (TAPSE) in 706 patients with HF and reduced EF (HFrEF). A persistently normal TAPSE (≥18 mm) or its improvement to normal during a 6‐month follow‐up were independent predictors of better long‐term survival . These data are consistent with other recent findings showing the prognostic value of the early improvement in RV function after specific interventions, such as cardiac resynchronization therapy …”

Six‐month outcome after transcatheter edge‐to‐edge repair of severe tricuspid regurgitation in patients with heart failure

“…Almost all of the treated patients suffered from secondary TR with right‐sided HF and 14 patients had isolated percutaneous TV repair for this entity. A desired effect of any therapeutic option in patients with right‐sided HF and severe TR beside TR reduction would be the stabilization or recovery of RV function, since RV dysfunction is associated with a worse prognosis in HF patients, irrespective of their left ventricular systolic function . Of note, current guidelines do not recommend surgery for isolated severe secondary TR with right‐sided HF.…”

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

“…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.…”