Key result
Worse RV-PA coupling is linked to higher NYHA functional class and NT-proBNP in heart transplant recipients.
Observational (n=69)
No
Answers are grounded in this paper and cite their sources.
In heart transplant recipients, reduced right ventricular/pulmonary arterial coupling (TAPSE/RVsys) is associated with worse functional status and higher NT-proBNP levels, suggesting its utility in long-term follow-up.
Background Right ventricular/pulmonary arterial coupling (RV/PA-coupling) is an increasingly recognized parameter to assess right ventricular function. It has been shown to correlate to functional status and prognosis in patients with heart failure. However, data regarding the applicability of RV/PA-coupling in Heart Transplant (HT) recipients remain scarce. A recent study investigated RV/PA-coupling within the first month post HT, finding better donor-recipient size matching to be associated to better short-term improvement of RV/PA-coupling. To our knowledge, there are no long-term data on RV/PA-coupling in HT recipients, even though evaluation of RV/PA-coupling might be especially interesting in the context of long-term graft failure. Purpose We aimed to investigate the clinical relevance of RV/PA-coupling in the long-term care of HT recipients. We hypothesized RV/PA-coupling assessed more than 1 year after HT to associate to functional status. Methods In this prospective, observational, single-centre study, HT recipients who underwent right heart catheterization with endomyocardial biopsy as part of routine follow up between 11/2016 and 12/2024. In 69 cases, corresponding echocardiographic data regarding right ventricular function was available We assessed RV/PA-coupling by dividing tricuspid annular plane systolic excursion (TAPSE) by right ventricular systolic pressure (RVsys) as described before. Right ventricular pressure was determined by right heart catheterization. Results The HT recipients were 71% male, had a mean age of 59 years, and a mean donor age of 45 years. Average time since transplantation was 49 months. Mean TAPSE was 17,22 ± 3.11mm. Mean right ventricular systolic pressure was 39 ± 10 mmHg. TAPSE/RVsys ratio correlated inversely to NYHA status (r = -.318, p = .009, Spearman correlation) and was significantly reduced in patients with NYHA class 3 or higher compared to patients with NYHA-class 1 (p = .025). TAPSE/RVsys ratio also correlated inversely to N-terminal pro brain natriuretic peptide (NT-proBNP) (n = 66, r = -.333, p = .007, Spearman correlation). Conclusion At a mean of 49 months after HT, reduced RV/PA-coupling was associated with higher NYHA class and higher NT-proBNP levels. This supports the utility of assessing RV/PA-coupling in heart transplant recipients to investigate right ventricular function in the long-term care of HT recipients. Future studies should evaluate the relevance of RV/PA-coupling as an outcome predictor in heart transplant recipients.
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Moos et al. (2025) conducted an observational in Heart transplant recipients (n=69). Right ventricular/pulmonary arterial coupling (TAPSE/RVsys ratio) was evaluated on NYHA status and NT-proBNP levels (r = -0.318, p=0.009). Right ventricular/pulmonary arterial coupling inversely correlated with NYHA status (r = -0.318, p = 0.009) and NT-proBNP levels (r = -0.333, p = 0.007) in heart transplant recipients.
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