Does right ventricular dysfunction (assessed by TAPSE/PASP) predict all-cause mortality across different heart failure phenotypes (HFrEF, HFmrEF, HFpEF)?
The TAPSE/PASP ratio is a powerful independent predictor of all-cause mortality across all heart failure phenotypes, despite differing clinical correlates of RV dysfunction between HFrEF and HFpEF/HFmrEF.
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.
Ghio et al. (Thu,) studied this question.