313 Prognostic value of different echocardiographic indices reflecting right ventriculo-arterial coupling in a large cohort of patients with various cardiac diseases

Autor: Diana Ruxandra Florescu, Denisa Muraru, Valentina Volpato, Michele Tomaselli, Sergio Caravita, Mara Gavazzoni, Cristina Florescu, Gianfranco Parati, Luigi Paolo Badano
Rok vydání: 2021
Předmět:
Zdroj: European Heart Journal Supplements. 23
ISSN: 1554-2815
1520-765X
DOI: 10.1093/eurheartj/suab132.019
Popis: Aims Non-invasive parameters used to assess right ventricular (RV) function, i.e. tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (FAC), RV ejection fraction (RVEF), and RV free-wall longitudinal strain (RVFWLS) have shown their prognostic implications. However, since they are extremely load dependent, they do not provide an accurate representation of the RV intrinsic performance. On the other end, invasive indices of RV-arterial coupling (RVAC) derived from pressure–volume loops are not routinely performed, rising the urgency for more feasible, and reliable non-invasive estimates of RVAC. To (i) evaluate the prognostic value of echocardiography-derived RVAC surrogates: RVEF/sPAP, RVFWLS/sPAP, TAPSE/sPAP, FAC/sPAP, and RV stroke volume/end-systolic volume (SV/ESV); (ii) identify the cut-off values associated to all-cause mortality; and (iii) compare their prognostic value with that of classical parameters of RV function. Methods and results We prospectively enrolled 366 patients with various cardiac diseases, undergoing clinically indicated comprehensive two- and three-dimensional echocardiography. During a mean follow-up of 7.6 ± 1 years, 80 (21.9%) patients died. At univariable Cox regression, most of the echocardiographic parameters were related to all-cause mortality. The echocardiographic parameters with significance at univariable analysis (P Conclusions RVAC surrogates provide incremental prognostic value compared to standard RV functional measurements. RVEF/sPAP, with a cut-off value of 1.5, was the best parameter for risk stratification, and was independently related to all-cause mortality.
Databáze: OpenAIRE
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