Different correlates but similar prognostic implications for right ventricular dysfunction in heart failure patients with reduced or preserved ejection fraction
Stefano Ghio,Marco Guazzi,Angela Beatrice Scardovi,Catherine Klersy,Francesco Clemenza,Erberto Carluccio,Pier Luigi Temporelli,Andrea Rossi,Pompilio Faggiano,Egidio Traversi,Olga Vriz,Frank Lloyd Dini +11 more
TLDR
To evaluate whether the clinical and echocardiographic correlates and the prognostic significance of right ventricular (RV) dysfunction are different in heart failure patients with reduced (HFrEF), mid‐range (HFmrEF), or preserved (HFpEF) left ventricular ejection fraction, a large number of patients with HFrEF, mid-range, or preserved patients are surveyed.Abstract:
Aims
To evaluate whether the clinical and echocardiographic correlates and the prognostic significance of right ventricular (RV) dysfunction are different in heart failure patients with reduced (HFrEF), mid-range (HFmrEF), or preserved (HFpEF) left ventricular ejection fraction.
Methods and results
The study included 1663 patients with heart failure caused by ischaemic or hypertensive heart disease or by idiopathic cardiomyopathy. Left ventricular ejection fraction was 40 mmHg was by far the strongest correlate of a reduced TAPSE in HFpEF and HFmrEF patients (interaction analysis, P = 0.0011). TAPSE/PASP proved to be a powerful predictor of prognosis in all patients.
Conclusions
The correlates of RV dysfunction differ in HFrEF compared with HFpEF and HFmrEF patients. Regardless of the extent of LV dysfunction, the TAPSE/PASP ratio is a powerful independent predictor of prognosis in all heart failure patients.read more
Citations
More filters
Journal ArticleDOI
RV Contractile Function and its Coupling to Pulmonary Circulation in Heart Failure With Preserved Ejection Fraction : Stratification of Clinical Phenotypes and Outcomes
Marco Guazzi,Debra Dixon,Valentina Labate,Lauren Beussink-Nelson,Francesco Bandera,Michael J. Cuttica,S.J. Shah +6 more
TL;DR: A thorough assessment of RV-PC coupling and RV contractile function stratify HFpEF phenotypes at different level of risk revealed the TAPSE/PASP ratio emerged as an independent predictor of worse outcomes.
Journal ArticleDOI
Pulmonary Hypertension in Heart Failure: Pathophysiology, Pathobiology, and Emerging Clinical Perspectives.
Marco Guazzi,Robert Naeije +1 more
TL;DR: Attention is focused on establishing a definitive consensus for a hemodynamic definition, perhaps incorporating exercise and fluid challenge, and searching for effective therapies that may benefit lung vessels and the remodeled right ventricle.
Journal ArticleDOI
Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology.
Thomas M. Gorter,Dirk J. van Veldhuisen,Johann Bauersachs,Barry A. Borlaug,Jelena Celutkiene,Andrew J.S. Coats,Andrew J.S. Coats,Marisa G. Crespo-Leiro,Marco Guazzi,Veli-Pekka Harjola,Stephane Heymans,Loreena Hill,Mitja Lainscak,Carolyn S.P. Lam,Lars H. Lund,Alexander R. Lyon,Alexandre Mebazaa,Christian Mueller,Walter Paulus,Burkert Pieske,Massimo F. Piepoli,Frank Ruschitzka,Frans H. Rutten,Petar M. Seferović,Scott D. Solomon,Sanjiv J. Shah,Filippos Triposkiadis,Rolf Wachter,Carsten Tschöpe,Rudolf A. de Boer +29 more
TL;DR: In this paper, the authors reviewed the prevalence, diagnosis, and pathophysiology of right heart dysfunction and failure in patients with heart failure with preserved ejection fraction (HFpEF) and discussed potential treatment strategies, important knowledge gaps and future directions regarding the right side in HFpEF.
Journal ArticleDOI
Right ventricular dysfunction in left-sided heart failure with preserved versus reduced ejection fraction.
Lena Bosch,Carolyn S.P. Lam,Lingli Gong,Siew Pang Chan,David Sim,Daniel Yeo,Fazlur Jaufeerally,Kui Toh Gerard Leong,Hean Yee Ong,Tze Pin Ng,Arthur Mark Richards,Fatih Arslan,Lieng H. Ling +12 more
TL;DR: Right ventricular dysfunction is recognized as a major prognostic factor in left‐sided heart failure (HF), however, the relative contribution of RV dysfunction in HF with preserved (HFpEF) vs. reduced ejection fraction (HFrEF) is unclear.
Journal ArticleDOI
Deterioration in right ventricular structure and function over time in patients with heart failure and preserved ejection fraction
TL;DR: Right ventricular structure and function deteriorate to greater extent over time when compared with changes in the left ventricle, and interventions targeting modifiable risk factors identified for incident RVD can prevent RVD and thus improve outcomes.
References
More filters
Journal ArticleDOI
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.
Piotr Ponikowski,Adriaan A. Voors,Stefan D. Anker,Héctor Bueno,John G.F. Cleland,Andrew J.S. Coats,Volkmar Falk,José Ramón González-Juanatey,Veli-Pekka Harjola,Ewa A. Jankowska,Mariell Jessup,Cecilia Linde,Petros Nihoyannopoulos,John Parissis,Burkert Pieske,Jillian P. Riley,Giuseppe M.C. Rosano,Luis M. Ruilope,Frank Ruschitzka,Frans H. Rutten,Peter van der Meer,Gerasimos Filippatos,John J.V. McMurray,Victor Aboyans,Stephan Achenbach,Stefan Agewall,Nawwar Al-Attar,John Atherton,Johann Bauersachs,A. John Camm,Scipione Carerj,Claudio Ceconi,Antonio Coca,Perry M. Elliott,Çetin Erol,Justin A. Ezekowitz,Covadonga Fernández-Golfín,Donna Fitzsimons,Marco Guazzi,Maxime Guenoun,Gerd Hasenfuss,Gerhard Hindricks,Arno W. Hoes,Bernard Iung,Tiny Jaarsma,Paulus Kirchhof,Juhani Knuuti,Philippe Kolh,Stavros Konstantinides,Mitja Lainscak,Patrizio Lancellotti,Gregory Y.H. Lip,Francesco Maisano,Christian Mueller,Mark C. Petrie,Massimo F Piepoli,Silvia G. Priori,Adam Torbicki,Hiroyuki Tsutsui,Dirk J. van Veldhuisen,Stephan Windecker,Clyde W. Yancy,José Luis Zamorano +62 more
TL;DR: Authors/Task Force Members: Piotr Ponikowski* (Chairperson) (Poland), Adriaan A. Voors* (Co-Chair person) (The Netherlands), Stefan D. Anker (Germany), Héctor Bueno (Spain), John G. F. Cleland (UK), Andrew J. S. Coats (UK)
Journal ArticleDOI
Recommendations for the evaluation of left ventricular diastolic function by echocardiography
Sherif F. Nagueh,Christopher P. Appleton,Thierry C. Gillebert,Paolo Marino,Jae K. Oh,Otto A. Smiseth,Alan D. Waggoner,Frank A. Flachskampf,Patricia A. Pellikka,Arturo Evangelisa +9 more
TL;DR: The assessment of left ventricular (LV) diastolic function and filling pressures is of paramount clinical importance to distinguish this syndrome from other diseases such as pulmonary disease resulting in dyspnea, to assess prognosis, and to identify underlying cardiac disease and its best treatment.
Journal ArticleDOI
The Natural History of Congestive Heart Failure: The Framingham Study
TL;DR: The natural history of congestive heart failure was studied over a 16-year period in 5192 persons initially free of the disease, finding that in almost every five-year age group, from 30 to 62 years, the incidence rate was greater for men than for women.
Journal ArticleDOI
Independent and additive prognostic value of right ventricular systolic function and pulmonary artery pressure in patients with chronic heart failure
Stefano Ghio,Antonello Gavazzi,Carlo Campana,C. Inserra,Catherine Klersy,R. Sebastiani,Eloisa Arbustini,Recusani F,Luigi Tavazzi +8 more
TL;DR: It was found that RVEF was preserved in some patients with pulmonary hypertension, and that the prognosis of these patients was similar to that of the patients with normal PAP, which emphasize the necessity of combining the right heart hemodynamic variables with a functional evaluation of the RV when trying to define the individual risk of patients with heart failure.
Journal ArticleDOI
Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure.
TL;DR: The goal of this review is to present a clinical perspective on RV physiology and pathobiology, which can result from any structural or functional cardiovascular disorder that impairs the ability of the RV to fill or to eject blood.
Related Papers (5)
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.
Piotr Ponikowski,Adriaan A. Voors,Stefan D. Anker,Héctor Bueno,John G.F. Cleland,Andrew J.S. Coats,Volkmar Falk,José Ramón González-Juanatey,Veli-Pekka Harjola,Ewa A. Jankowska,Mariell Jessup,Cecilia Linde,Petros Nihoyannopoulos,John Parissis,Burkert Pieske,Jillian P. Riley,Giuseppe M.C. Rosano,Luis M. Ruilope,Frank Ruschitzka,Frans H. Rutten,Peter van der Meer,Gerasimos Filippatos,John J.V. McMurray,Victor Aboyans,Stephan Achenbach,Stefan Agewall,Nawwar Al-Attar,John Atherton,Johann Bauersachs,A. John Camm,Scipione Carerj,Claudio Ceconi,Antonio Coca,Perry M. Elliott,Çetin Erol,Justin A. Ezekowitz,Covadonga Fernández-Golfín,Donna Fitzsimons,Marco Guazzi,Maxime Guenoun,Gerd Hasenfuss,Gerhard Hindricks,Arno W. Hoes,Bernard Iung,Tiny Jaarsma,Paulus Kirchhof,Juhani Knuuti,Philippe Kolh,Stavros Konstantinides,Mitja Lainscak,Patrizio Lancellotti,Gregory Y.H. Lip,Francesco Maisano,Christian Mueller,Mark C. Petrie,Massimo F Piepoli,Silvia G. Priori,Adam Torbicki,Hiroyuki Tsutsui,Dirk J. van Veldhuisen,Stephan Windecker,Clyde W. Yancy,José Luis Zamorano +62 more
Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging.
Roberto M. Lang,Luigi P. Badano,Victor Mor-Avi,Jonathan Afilalo,Anderson C. Armstrong,Laura Ernande,Frank A. Flachskampf,Elyse Foster,Steven A. Goldstein,Tatiana Kuznetsova,Patrizio Lancellotti,Denisa Muraru,Michael H. Picard,Ernst Rietzschel,Lawrence G. Rudski,Kirk T. Spencer,Wendy Tsang,Jens-Uwe Voigt +17 more
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Piotr Ponikowski,Adriaan A. Voors,Stefan D. Anker,Héctor Bueno,John G.F. Cleland,Andrew J.S. Coats,Volkmar Falk,José Ramón González-Juanatey,Veli-Pekka Harjola,Ewa A. Jankowska,Mariell Jessup,Cecilia Linde,Petros Nihoyannopoulos,John Parissis,Burkert Pieske,Jillian P. Riley,Giuseppe M.C. Rosano,Luis M. Ruilope,Frank Ruschitzka,Frans H. Rutten,Peter van der Meer +20 more