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Prognostic Value of Non-Invasively Determined Right Ventricular-Arterial Coupling Surrogate Parameters in Patients
Maria Iovănescu1,2, Diana-Ruxandra Hădăreanu1,2, Despina Toader2
1Department of Cardiology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Insights
Echocardiography-derived right ventricular-arterial (RV-PA) coupling indices, specifically RVFWLS/PASP and RVEF/PASP, can predict rehospitalization risk in dilated cardiomyopathy (DCM) patients.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure
Background:
- Right ventricular dysfunction is common in dilated cardiomyopathy (DCM).
- It significantly impacts patient prognosis.
- Assessing right ventricular-arterial (RV-PA) coupling is crucial.
Purpose of the Study:
- To evaluate echocardiography-derived surrogate parameters of RV-PA coupling.
- To determine their prognostic value in DCM patients.
Main Methods:
- Retrospective and prospective assessment of 88 DCM patients.
- Follow-up for a mean of 14 months.
- Analysis of TAPSE/PASP, RVFAC/PASP, RVFWLS/PASP, and RVEF/PASP for rehospitalization and mortality.
Main Results:
- All studied indices were associated with rehospitalization in univariate analysis.
- RVFWLS/PASP and RVEF/PASP were independent predictors in multivariate analysis.
- Optimal cut-offs identified: RVEF/PASP at 1.2 and RVFWLS/PASP at 0.46.
Conclusions:
- Non-invasively derived RV-PA coupling indices offer prognostic utility.
- These indices aid in stratifying rehospitalization risk in DCM.
- No significant correlation found with all-cause mortality.
Abstract:
Background/Objectives: Right ventricular dysfunction is frequent in patients with dilated cardiomyopathy (DCM) and contributes significantly to prognosis. This study evaluated the prognostic value of echocardiography-determined surrogate parameters of right ventricular-arterial (RV-PA) coupling in patients with DCM. Methods: A total of 88 patients admitted between January 2019 to September 2023 were retrospectively and prospectively assessed and followed for a mean of 14 months. The primary endpoint was rehospitalization for decompensated heart failure (HF); the secondary endpoint was all-cause mortality. The parameters studied included TAPSE/PASP, RVFAC/PASP, RVFWLS/PASP, and RVEF/PASP. Results: In univariate analysis, all indices were associated with rehospitalization, but multivariate analysis retained only RVFWLS/PASP and RVEF/PASP as independent predictors. Optimal cut-offs were identified as 1.2 for RVEF/PASP (sensitivity 72%, specificity 80%) and 0.46 for RVFWLS/PASP (sensitivity 72%, specificity 76%). None of the parameters correlated significantly with all-cause mortality. Conclusions: These findings highlight the prognostic utility of non-invasively derived RV-PA coupling indices for rehospitalization risk stratification in DCM.
