Right Ventricular–Pulmonary Artery Coupling Predicts Early Myocardial Strain Improvement in SGLT2 Inhibitor-Treated HFrEF

Figures

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  Fig. 1. Relationship between change in left ventricular global longitudinal strain (ΔLV-GLS) and change in right ventricular free-wall strain (ΔRVFWS). A significant positive correlation was observed between improvements in LV and RV myocardial deformation (r = 0.62, p < 0.001), indicating parallel biventricular reverse remodelling.

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  Fig. 2. Relationship between change in right ventricular free-wall strain (ΔRVFWS) and change in 6-min walk distance (Δ6MWD). Improvement in RV myocardial deformation was significantly associated with greater improvement in exercise capacity, as demonstrated by the inverse correlation between ΔRVFWS and Δ6MWD (r = −0.67, p < 0.001).

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  Fig. 3. Relationship between change in right ventricular free-wall strain (ΔRVFWS) and change in quality of life (ΔQoL). Improvement in RV myocardial deformation was significantly associated with greater improvement in patient-reported quality of life (r = −0.62, p < 0.001).

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  Fig. 4. Receiver operating characteristic (ROC) analysis demonstrating that baseline tricuspid annular plane systolic excursion to pulmonary artery systolic pressure ratio (TAPSE/PASP) predicted right ventricular strain improvement with good discriminative ability (area under the curve [AUC] 0.84, 95% confidence interval [CI] 0.72–0.95, p < 0.001). A cutoff value of 0.39 yielded 76% sensitivity and 84% specificity for identifying responders.