Right ventricular-vascular coupling in heart failure with preserved ejection fraction and pre- vs. post-capillary pulmonary hypertension

European Heart Journal Cardiovascular Imaging
Thomas M GorterElke S Hoendermis

Abstract

Many patients with heart failure with preserved ejection fraction (HFpEF) develop post-capillary pulmonary hypertension (PH) due to increased left-sided filling pressures. However, a subset of patients develops combined post- and pre-capillary PH. We studied the value of echocardiographic right-sided characterization for the discrimination between pre- vs. post-capillary PH in HFpEF, using invasive haemodynamics as gold standard. 102 consecutive HFpEF patients with simultaneous right heart catheterization and echocardiography were identified. Patients were divided into: 'no PH', 'isolated post-capillary PH', and 'post- and pre-capillary PH'. Systolic pulmonary arterial pressure (SPAP), tricuspid valve annular plane systolic excursion (TAPSE), right ventricular-vascular coupling (TAPSE/SPAP), and VO2-max were assessed. Primary endpoint was all-cause mortality. A total of 97 patients were included: 22% no PH, 47% isolated post-capillary PH, and 31% post- and pre-capillary PH. Patients with post- and pre-capillary PH had more often diabetes mellitus (47 vs. 24%, P = 0.04), had more heart failure hospitalizations (57 vs. 26%, P = 0.007) and lower VO2-max (10 vs. 13 mL/min/kg, P = 0.008), compared with those with isolated post-capil...Continue Reading

References

Mar 19, 2013·Journal of the American College of Cardiology·Dirk J van VeldhuisenHans L Hillege
Jan 7, 2015·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Roberto M LangJens-Uwe Voigt
Apr 4, 2015·The Canadian Journal of Cardiology·Thenappan ThenappanSanjiv J Shah
Feb 26, 2016·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·A E Huis In 't VeldM L Handoko
Sep 22, 2016·European Journal of Heart Failure·Thomas M GorterJoost P van Melle

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Citations

Nov 18, 2017·European Journal of Heart Failure·Alberto PalazzuoliCarlo Lombardi
Dec 11, 2019·Journal of Clinical Medicine·Yannis DimitroglouDimitris Tousoulis
Jun 6, 2020·European Journal of Heart Failure·Thomas M GorterMichael G Dickinson
Oct 21, 2017·European Journal of Heart Failure·Stephan Rosenkranz, Marius M Hoeper
Jul 12, 2018·European Heart Journal·Vanessa van Empel, Hans-Peter Brunner-La Rocca
Jun 16, 2018·European Heart Journal·Carolyn S P LamDirk J van Veldhuisen
Sep 13, 2019·European Heart Journal·Masaru ObokataBarry A Borlaug
Jun 19, 2019·European Heart Journal Cardiovascular Imaging·Thor EdvardsenBernard Cosyns
Apr 4, 2021·Journal of Clinical Medicine·Blanca Trejo-VelascoIgnacio Cruz-González
Apr 20, 2021·Circulation. Heart Failure·Marco Guazzi, Robert Naeije
Jun 11, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Andreas J RiethChristian W Hamm
Jul 24, 2021·JACC. Cardiovascular Interventions·Nicole Karam, Jörg Hausleiter
Jul 13, 2020·JACC. Heart Failure·Thomas M GorterDirk J van Veldhuisen
Oct 7, 2021·Journal of the American Heart Association·Akito NakagawaUNKNOWN Osaka CardioVascular Conference (OCVC)‐Heart Failure investigators

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