Daniel Grados-Saso, Unidad de Cardiología, Hospital de Barbastro, Huesca, España
Ana M. Martínez-Royo, Unidad de Cardiología, Hospital de Barbastro, Huesca, España
Juan M. Salvador, Unidad de Cardiología, Hospital de Barbastro, Huesca, España
Patricia Irigaray-Sierra, Unidad de Cardiología, Hospital de Barbastro, Huesca, España
Gloria Romero-Hervás, Unidad de Cardiología, Hospital de Barbastro, Huesca, España
Introduction: the right ventricle and pulmonary circulation play a fundamental role in the pathophysiology of heart failure (HF). In this context, it may be of particular interest to evaluate not only right ventricular function but also the coupling between the RV and pulmonary circulation. Several studies have proposed the TAPSE/PAPs ratio (ratio between tricuspid annular plane systolic excursion/TAPSE) and pulmonary artery systolic pressure (PAPs) as a relatively simple measure that provides information on right ventricular-arterial coupling with a potential prognostic role in patients with HF. Objective: to evaluate the prognostic value of the TAPSE/PAPS and SLpVD/PAPs (right ventricular strain) ratio in patients with heart failure and preserved or mild reduced ejection fraction. Methods: a prospective cohort design was used, including patients with confirmed HF who had been admitted to hospital due to decompensation. The TAPSE/PAPS and SLpVD/PAPs indices were quantified. Their relationship with cardiovascular mortality was studied. Results: the SLpVD/PAPs ratio was statistically significantly associated with cardiovascular mortality at 6 months (p = 0.021). In contrast, the TAPSE/PAPs ratio showed no association with cardiovascular mortality (p = 0.24). Conclusions: longitudinal strain of the right ventricular free wall and its ratio to PAPs (RV strain/PAPs) as a parameter of right ventricular-arterial coupling are indicative of unfavourable outcomes in patients with HF, proving to be powerful predictors of cardiovascular mortality.
Keywords: Heart failure. Strain. Right ventricle.
