Related Experiment Video
Updated: Jul 29, 2025
07:38
Comprehensive Echocardiographic Assessment of Right Ventricle Function in a Rat Model of Pulmonary Arterial Hypertension
Published on: January 20, 2023
3.7K
Right Ventricular Function and Pulmonary Coupling in Patients With Heart Failure and Preserved Ejection Fraction
Riccardo M Inciardi1, Martin Abanda2, Amil M Shah3
1Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA; Division of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Journal of the American College of Cardiology
|May 24, 2023
Summary
Impaired right ventricular (RV) function is common in heart failure with preserved ejection fraction (HFpEF) and predicts adverse events. Worsening RV function and its ratio to pulmonary pressure increase HF hospitalizations and cardiovascular death risk.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Limited data characterize novel right ventricular (RV) function measures in heart failure with preserved ejection fraction (HFpEF).
- Understanding RV function and its coupling to pulmonary circulation is crucial in HFpEF management.
- Investigating RV dysfunction is key to identifying risks in HFpEF patients.
Purpose of the Study:
- Assess clinical implications of RV function in HFpEF.
- Examine the association between RV function, N-terminal pro-B-type natriuretic peptide, and adverse events.
- Evaluate RV free wall longitudinal strain (RVFWLS) and RVFWLS/pulmonary artery systolic pressure (PASP) ratio in HFpEF.
Main Methods:
- Analyzed RVFWLS and RVFWLS/PASP ratio in 528 HFpEF patients from the PARAGON-HF trial.
- Assessed associations with baseline N-terminal pro-B-type natriuretic peptide.
- Evaluated risk for HF hospitalizations and cardiovascular death after accounting for confounders.
Main Results:
- 58% of patients exhibited RV dysfunction (absolute RVFWLS <20%).
- Lower RVFWLS and RVFWLS/PASP ratios correlated with higher N-terminal pro-B-type natriuretic peptide levels.
- Both RVFWLS and RVFWLS/PASP ratio significantly predicted composite outcomes of HF hospitalizations and cardiovascular death.
Conclusions:
- Worsening RV function and its ratio to pulmonary pressure are common in HFpEF.
- Impaired RV function significantly increases the risk of HF hospitalizations and cardiovascular death.
- RV function measures did not modify the treatment effect of sacubitril/valsartan.
Related Concept Videos
01:29Heart Failure II: Pathophysiology
17
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
17
01:17Pathophysiology of Heart Failure
1.7K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.7K
01:22Mitral Stenosis I: Introduction
19
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
19
01:20Mitral Regurgitation I: Introduction
20
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
20
01:26Imbalances in Cardiac Output
1.4K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
01:30Cardiomyopathy II: Dilated Cardiomyopathy
12
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
12