Right ventricular systolic dysfunction (RVEF <45%) assessed by CMR was independently associated with cardiac events in patients with HFpEF (P<0.001).
Cohort (n=171)
Does right ventricular systolic dysfunction assessed by CMR predict cardiac events in patients with heart failure with preserved ejection fraction?
Right ventricular systolic dysfunction assessed by CMR is an independent predictor of mortality and clinical events in patients with HFpEF, providing a useful tool for risk stratification.
p-value: p=<0.001
AIMS: Recent data indicate that right ventricular systolic dysfunction (RVSD) by cardiac magnetic resonance imaging (CMR) is a strong predictor of outcome in heart failure. However, the prognostic significance of RVSD by CMR in heart failure with preserved ejection fraction (HFpEF) is unknown. METHODS AND RESULTS: We prospectively enrolled 171 HFpEF patients who underwent CMR in addition to invasive and non-invasive testing. RVSD, defined as right ventricular (RV) EF <45% by CMR, was present in 33 (19.3 %) patients. Patients were followed for 573 ± 387 days, during which 41 had a cardiac event. Patients with RVSD presented with more frequent history of AF (P = 0.038), significantly higher resting heart rate (P = 0.009), shorter 6-min walk distance (P = 0.036), and higher NT-pro BNP serum levels (P < 0.001), and were more symptomatic (P < 0.001). With respect to haemodynamic parameters, RVSD was associated with respect to haemodynamic parameters, RVSD was associated with higher diastolic pulmonary artery pressure (P = 0.045), with higher pulmonary vascular resistance (P = 0.048), higher transpulmonary gradient (P = 0.042), and higher diastolic pulmonary vascular pressure gradient (P = 0.007). In the multivariable Cox analysis, RVSD (P < 0.001) remained significantly associated with cardiac events, in addition to diabetes (P = 0.011), 6-min walk distance (P = 0.018), and systolic pulmonary artery pressure (P = 0.003). CONCLUSIONS: Although HFpEF is considered a disease of the left ventricle, respective imaging parameters are not related to outcome. In contrast, RVSD by CMR is independently associated with mortality and clinical status in these patients, and provides a useful tool for risk stratification.
Aschauer et al. (Fri,) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) (n=171). Right ventricular systolic dysfunction (RVSD) by CMR vs. No RVSD was evaluated on Cardiac events (p=<0.001). Right ventricular systolic dysfunction (RVEF <45%) assessed by CMR was independently associated with cardiac events in patients with HFpEF (P<0.001).