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Updated: May 26, 2026

Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
Published on: November 26, 2018
Right ventricular-pulmonary arterial coupling may discriminate late right heart failure outcomes in left ventricular
Alexandra I Mansour1, Bhavya Ancha1, Fatimah Alkhunaizi1
1Johns Hopkins University Division of Cardiology, DOM, Baltimore, Maryland.
Abstract:
Right ventricular-pulmonary arterial (RV-PA) coupling more sensitively captures RV dysfunction and may identify those at risk for late right heart failure (LRHF). Fourteen left ventricular assist device patients underwent prospective RV pressure-volume loop assessment and outcome adjudication. RV-PA coupling was indexed by the ratio of pressure-volume-derived RV end-systolic elastance (Ees) to pulmonary arterial elastance (Ea). Receiver operating curves compared the ability of Ees/Ea with standard hemodynamic metrics to discriminate LRHF outcomes. Freedom from LRHF or cardiovascular-related death was compared between those above and below the Ees/Ea value with optimal sensitivity and specificity for LRHF (Ees/Ea = 0.36). Ees/Ea best discriminated LRHF outcomes (AUC 0.92; p = 0.002) compared with PAPi, RA/PCWP, and RVSWI (AUC 0.65, 0.71, 0.50). Patients with an Ees/Ea ≤ 0.36 (n = 7) were more likely to develop LRHF by 3-year follow-up compared with an Ees/Ea >0.36 (log-rank p = 0.004). RV Ees/Ea may discriminate LRHF outcomes and characterize subclinical RV dysfunction that may precede LRHF.
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