Heart failure & cardiomyopathies
Multiparametric Right Ventricular Assessment Improves Risk Stratification in Patients with New-Onset Acute Heart Failure
Main finding · Composite of all-cause mortality, LV assist device implantation and heart transplantationResult — go to the resultHazard ratio 3.11 95% CI 1.44–6.74Authors' conclusion
A novel multiparametric RVD score might improve prognostic stratification in patients with new-onset AHF. RVD after therapy titration, but not at index hospitalization is associated with a higher risk of the composite endpoint.
Study context
- Population
- Patients hospitalised with new-onset acute HF, 2015–2018 (mean age 56 ± 10 years, 24% female, median LVEF 28%)
- Participants
- 210 patients
- Exposure
- Right ventricular dysfunction (RVD) score ≥2 vs tricuspid annular plane systolic excursion (TAPSE) <17 mm vs fractional area change (FAC) <35% after therapy titration
- With endpointn = 53
- Outcome
- Composite of:
- All-cause mortality
- LV assist device implantation
- Heart transplantation
- Follow-up
- 60 months median
Main finding
As reported in the abstract
Hazard ratio
3.11
95% CI 1.44–6.74
RVD score ≥2 after therapy titration
HR 3.11 (95% CI 1.44–6.74)
- Patients meeting the endpoint
- 53 (25%)
- After therapy titration, with vs without endpoint: TAPSE (mm)
- 16 vs. 19 mm, P = 0.001
- After therapy titration, with vs without endpoint: FAC
- 33 vs. 40%, P < 0.001
- After therapy titration, with vs without endpoint: RVD score ≥2
- 36 vs. 4%, P < 0.001
- Event-free at 1 year, TAPSE <17 mm
- 87%
- Event-free at 1 year, FAC <35%
- 89%
- Event-free at 1 year, RVD score ≥2
- 65%
Observational data: associations, not effects.
Further findings
Event-free at 1 year, by RVD despite therapy titration
Echocardiographic parameters at index hospitalisation
- No significant differences in any echocardiographic parameter between patients with and without the endpoint
Original publication
Multiparametric Right Ventricular Assessment Improves Risk Stratification in Patients with New-Onset Acute Heart Failure. ESC Heart Fail. Published 5 July 2024. doi:10.
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