Key result
Impaired RV-PA coupling indices independently predict heart failure rehospitalization in dilated cardiomyopathy.
Why the study?
Right ventricular dysfunction is frequent in dilated cardiomyopathy and significantly affects prognosis, but the prognostic value of echocardiographic RV-PA coupling surrogate parameters required evaluation.
Do non-invasively determined right ventricular-arterial coupling surrogate parameters predict rehospitalization for decompensated heart failure in patients with dilated cardiomyopathy?
Cohort (n=88)
No
Do non-invasively determined right ventricular-arterial coupling surrogate parameters predict rehospitalization for decompensated heart failure in patients with dilated cardiomyopathy?
p-value: p=0.001
Integrating echocardiographic right ventricular-arterial coupling indices, particularly RVEF/PASP and RVFWLS/PASP, may improve prognostic stratification and identify patients with dilated cardiomyopathy at higher risk for recurrent heart failure hospitalizations.
RV–PA coupling indices may refine rehospitalization risk stratification in dilated cardiomyopathy; leaves open prospective validation before clinical adoption.
Background/Objectives: Right ventricular dysfunction is frequent in patients with dilated cardiomyopathy (DCM) and contributes significantly to prognosis. This study evaluated the prognostic value of echocardiography-determined surrogate parameters of right ventricular–arterial (RV–PA) coupling in patients with DCM. Methods: A total of 88 patients admitted between January 2019 to September 2023 were retrospectively and prospectively assessed and followed for a mean of 14 months. The primary endpoint was rehospitalization for decompensated heart failure (HF); the secondary endpoint was all-cause mortality. The parameters studied included TAPSE/PASP, RVFAC/PASP, RVFWLS/PASP, and RVEF/PASP. Results: In univariate analysis, all indices were associated with rehospitalization, but multivariate analysis retained only RVFWLS/PASP and RVEF/PASP as independent predictors. Optimal cut-offs were identified as 1.2 for RVEF/PASP (sensitivity 72%, specificity 80%) and 0.46 for RVFWLS/PASP (sensitivity 72%, specificity 76%). None of the parameters correlated significantly with all-cause mortality. Conclusions: These findings highlight the prognostic utility of non-invasively derived RV–PA coupling indices for rehospitalization risk stratification in DCM.
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Iovănescu et al. (2026) conducted a cohort in Dilated Cardiomyopathy (DCM) (n=88). Non-invasively determined right ventricular-arterial (RV-PA) coupling surrogate parameters (RVEF/PASP and RVFWLS/PASP) vs. Reference values or unexposed/optimal values was evaluated on Rehospitalization for decompensated heart failure (p=0.001). RVEF/PASP (cut-off 1.2) and RVFWLS/PASP (cut-off 0.46) were significant independent predictors of rehospitalization for decompensated heart failure in patients with dilated cardiomyopathy.
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