Prognostic Value of the RVFWLS/PASP Ratio in Pulmonary Arterial Hypertension

Area of Science:

• Cardiology
• Pulmonology
• Echocardiography

Background:

• Right ventricular-pulmonary artery (RV-PA) coupling is crucial in pulmonary arterial hypertension (PAH).
• The RVFWLS/PASP ratio is an emerging echocardiographic index for assessing RV-PA coupling.

Purpose of the Study:

• To evaluate the prognostic significance of the RVFWLS/PASP ratio in PAH patients.
• To assess its incremental value in risk stratification for PAH patients.

Main Methods:

• Retrospective-prospective cohort study of 149 adult PAH patients.
• RVFWLS measured by speckle tracking echocardiography; PASP estimated by Doppler.
• Primary endpoint: event-free survival (mortality, lung transplant, right heart failure hospitalization).

Main Results:

• Lower RVFWLS/PASP (<0.246%/mmHg) associated with worse exercise capacity, higher NT-proBNP, and poorer hemodynamics.
• Reduced RVFWLS/PASP significantly correlated with lower event-free survival.
• RVFWLS/PASP ≥ 0.246%/mmHg independently predicted reduced risk (HR=0.46, p<0.05).

Conclusions:

• RVFWLS/PASP is a robust, independent predictor of long-term prognosis in PAH.
• This noninvasive measure of RV-PA coupling enhances clinical risk assessment and treatment monitoring.