Key result
An abnormal right ventricular free wall strain to pulmonary artery systolic pressure ratio (<0.3) was significantly associated with higher cardiovascular mortality at six months in patients with heart failure.
Why the study?
Does the RVFWS/PASP ratio predict cardiovascular mortality in patients with heart failure with preserved or mildly reduced ejection fraction?
Cohort (n=71)
No
Does the RVFWS/PASP ratio predict cardiovascular mortality in patients with heart failure with preserved or mildly reduced ejection fraction?
The RVFWS/PASP ratio, but not the TAPSE/PASP ratio, is a significant predictor of 6-month cardiovascular mortality in patients with heart failure with preserved or mildly reduced ejection fraction.
Introduction: The right ventricle (RV) and pulmonary circulation play a fundamental role in the pathophysiology of heart failure (HF).In this context, it may be of particular interest to evaluate not only right ventricular function but also the coupling between the RV and pulmonary circulation.Several studies have proposed the tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) ratio as a relatively simple measure that provides information on right ventricular-arterial coupling with a potential prognostic role in patients with HF.Objective: To evaluate the prognostic value of the TAPSE/PASP and right ventricular strain (RVFWS)/PASP ratios in patients with heart failure and preserved or mildly reduced ejection fraction.Methods: A prospective cohort design was used, including patients with confirmed HF who had been admitted to the hospital due to decompensation.The TAPSE/PASP and RVFWS/PASP indices were quantified, and their relationship with cardiovascular mortality was studied.Results: The RVFWS/PASP ratio was statistically significantly associated with cardiovascular mortality at six months (p = 0.021).In contrast, the TAPSE/PASP ratio showed no association with cardiovascular mortality (p = 0.24).Conclusions: Longitudinal strain of the right ventricular free wall and its ratio to PASP (RVFWS/PASP), as a right ventricular-arterial coupling parameter, are indicative of unfavorable outcomes in patients with HF, proving to be powerful predictors of cardiovascular mortality.
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Grados-Saso et al. (2026) conducted a cohort in Heart failure with preserved or mildly reduced ejection fraction (n=71). Abnormal right ventricular free wall strain to pulmonary artery systolic pressure (RVFWS/PASP) ratio (<0.3) vs. Normal RVFWS/PASP ratio (≥0.3) was evaluated on Cardiovascular mortality at 6 months (p=0.008). An abnormal right ventricular free wall strain to pulmonary artery systolic pressure ratio (<0.3) was significantly associated with higher cardiovascular mortality at six months in patients with heart failure.
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