Combined use of right ventricular coupling and pulmonary arterial elastance as a comprehensive stratification approach for right ventricular function

Figures

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  FIGURE 1. Illustration of the estimation of BSP and ESP using the second derivative method. The red curve represented the RV pressure waveform, the blue curve represented the fitted sine wave, and the dotted curve represented the square of the second derivative of the RV pressure waveform. With the elevation of RV systolic pressure, the wave peak of the pressure waveform was gradually shifted to the right, and RV systolic pressure differential gradually increased from negative to positive. BSP, beginning‐systolic pressure; EDP, end‐diastolic pressure; ESP, end‐systolic pressure; PA, pulmonary arterial; RV, right ventricular; RVP, right ventricular pressure.

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  FIGURE 2. Pulmonary hemodynamic phenotypes in patients stratified by Ees/Ea and Ea. (a) Distribution of RV Ees and PA Ea, with differently colored scatter plots representing different pulmonary hemodynamic phenotypes. The two dotted lines indicated an Ees/Ea cutoff of 0.80, and an Ea cutoff of 0.59 mmHg/mL. (b) Percent bar graph of patients with different pulmonary hemodynamic phenotypes by group. Cpc‐PH, combined post‐capillary and pre‐capillary pulmonary hypertension; Ea, arterial elastance; Ees, end‐systolic elastance; Ipc‐PH, isolated post‐capillary pulmonary hypertension; No‐PH, without pulmonary hypertension; PA, pulmonary arterial; RV, right ventricular.

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  FIGURE 3. Survival analysis. Kaplan–Meier estimates of time to event‐free survival (a), all‐cause mortality (b), and all‐cause mortality‐censored (c) stratified by Ees/Ea ratio and Ea into four groups. Ea, arterial elastance; Ees, end‐systolic elastance.

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  FIGURE 4. Survival analysis. Kaplan–Meier estimates of time to event‐free survival (a, d), all‐cause mortality (b, e), and all‐cause mortality‐censored (c, f) stratified by Ees/Ea ratio and Ea into three groups. Ea, arterial elastance; Ees, end‐systolic elastance.

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  FIGURE 5. Association of the RV systolic pressure differential with Ees/Ea ratio and Ea. (a) Correlation between Ees/Ea ratio and ESP–BSP. (b) Correlation between Ea and ESP‐BSP. (c) Percent bar graph of patients with preserved/impaired Ees/Ea ratio and/or normal/elevated Ea classified according to the value of ESP–BSP. (d) Kaplan–Meier estimates of time to event‐free survival stratified by ESP–BSP into three groups. BSP, beginning‐systolic pressure; Ea, arterial elastance; Ees, end‐systolic elastance; ESP, end‐systolic pressure; RV, right ventricular.