Heart failure & cardiomyopathies
Integrating Resistant and Pulsatile Right Ventricular Load Improves Severity Assessment in Heart Failure Patients
Main finding · All-cause mortality or a left ventricular assist device implantationResult — go to the resultAdjusted hazard ratio 4.42 95% CI 1.86–10.6Authors' conclusion
We describe a novel RV afterload score that improves severity grading and prognostication compared with current ESC/ERS phenotypes and define PVR-intervals that might be helpful for therapy individualization and in upcoming trials with new therapeutic targets.
Study context
- Population
- Patients with reduced left ventricular ejection fraction (<50%) referred for right heart catheterization
- Participants
- 328 patients
- Exposure
- severity-grading of right ventricular (RV) afterload using the current pulmonary hypertension definition with a novel RV afterload score
- Outcome
- All-cause mortality or a left ventricular assist device implantation
Main finding
As reported in the abstract
All-cause mortality or a left ventricular assist device implantation
Adjusted hazard ratio
4.42
95% CI 1.86–10.6
High RV afterload score vs Low RV afterload score
adjusted HR 4.42 (95% CI 1.86–10.6)
- Prognostic value of RV afterload score vs ESC/ERS phenotypes
- P = 0.010
Observational data: associations, not effects.
Further findings
Severity stratification (RV function, cardiac index, pulmonary artery wedge pressure)
- Stepwise significant differences with the RV afterload score
- P < 0.001
PVR-PAC relation
- Hyperbolic PVR-PAC relation R2
- 0.48
- PVR ≤2 WU
- 56% low and 44% intermediate
- PVR 2.1 to 3.9 WU
- 67% intermediate and 33% high load
- PVR ≥4 WU
- 100% high afterload score
Original publication
Integrating Resistant and Pulsatile Right Ventricular Load Improves Severity Assessment in Heart Failure Patients. JACC Adv. doi:10.
Summarised from the published abstract; every number is checked against it