The VIRTUE Index: A Novel Echocardiographic Marker Integrating Right–Left Ventricular Hemodynamics in Acute Heart Failure

Figures

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  Figure 1. Flow diagram illustrating patient selection and subgroup allocation; Abbreviations: LVEF—left ventricular ejection fraction; HFrEF—heart failure with reduced ejection fraction; HFpEF—heart failure with preserved ejection fraction; TAPSE—tricuspid annular plane systolic excursion; LVOT VTI—left ventricular outflow tract velocity–time integral; TR—tricuspid regurgitation.

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  Figure 2. Receiver operating characteristic (ROC) curves illustrating the predictive performance of the Virtue Index and conventional echocardiographic parameters for in-hospital mortality in patients with HFpEF. RV–RA gradient = right ventricular to right atrial pressure gradient; TAPSE = tricuspid annular plane systolic excursion; LVOT VTI = left ventricular outflow tract velocity–time integral; Yellow dotted line = reference line (AUC = 0.5).

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  Figure 3. Receiver operating characteristic (ROC) curves illustrating the predictive performance of the Virtue Index and conventional echocardiographic parameters for in-hospital mortality in patients with HFrEF. RV–RA gradient = right ventricular to right atrial pressure gradient; TAPSE = tricuspid annular plane systolic excursion; LVOT VTI = left ventricular outflow tract velocity–time integral; Yellow dotted line = reference line (AUC = 0.5).

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  Figure 4. Receiver operating characteristic (ROC) curves comparing the Virtue Index and NT-proBNP for in-hospital mortality prediction in patients with HFrEF; Dotted line = reference line (AUC = 0.5).

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  Figure 5. Receiver operating characteristic (ROC) curves comparing the Virtue Index and NT-proBNP for in-hospital mortality prediction in patients with HFpEF; Dotted line = reference line (AUC = 0.5).