The RVFWLS/sPAP ratio was an independent predictor of heart failure rehospitalization or all-cause mortality (HR 0.110) in patients with HFrEF and ventricular secondary mitral regurgitation.
Cohort (n=104)
No
Does the RVFWLS/sPAP ratio predict adverse outcomes in patients with HFrEF and V-sMR?
The RVFWLS/sPAP ratio is a robust, independent prognostic marker in HFrEF patients with V-sMR, offering incremental prognostic information beyond conventional echocardiographic parameters.
Effect estimate: HR 0.110 (95% CI 0.012-0.992)
p-value: p=0.049
Background In heart failure (HF) with reduced ejection fraction (HFrEF), ventricular secondary mitral regurgitation (V-sMR) leads to progressive impairment of right ventricular (RV) function and adversely affects outcomes. Non-invasive indices of RV–pulmonary artery (RVPA) coupling may offer enhanced prognostic value. Methods We retrospectively evaluated advanced echocardiographic surrogates of RVPA coupling in 104 HFrEF patients with V-sMR. Results Over a median follow-up of 526 days, 48 patients (46.2%) reached the composite endpoint of rehospitalization for HF decompensation or all-cause mortality. Patients who experienced events had significantly larger RV volumes, lower RV functional indices, and higher systolic pulmonary artery pressure (sPAP) compared with those without events. Among the RVPA coupling measures, the ratio of RV free-wall longitudinal strain (RVFWLS) to sPAP had the highest predictive accuracy (area under the curve 0.730), with an optimal cut-off of 0.46%/mmHg (71% sensitivity, 69% specificity). Kaplan–Meier analysis showed significantly lower event-free survival for patients with RVFWLS/sPAP 0.46%/mmHg (log-rank p = 0.001). In multivariable Cox regression analysis, RVFWLS/sPAP (hazard ratio 0.110, 95% confidence interval 0.012–0.992; p = 0.049) emerged as an independent predictor of adverse outcomes. Conclusion The RVFWLS/sPAP ratio, with a cut-off value of 0.46%/mmHg, is a robust, independent prognostic marker in HFrEF patients with V-sMR.
Hădăreanu et al. (Tue,) conducted a cohort in Heart failure with reduced ejection fraction and ventricular secondary mitral regurgitation (n=104). RVFWLS/sPAP ratio was evaluated on Composite of rehospitalization for heart failure decompensation or all-cause mortality (HR 0.110, 95% CI 0.012-0.992, p=0.049). The RVFWLS/sPAP ratio was an independent predictor of heart failure rehospitalization or all-cause mortality (HR 0.110) in patients with HFrEF and ventricular secondary mitral regurgitation.