Heart failure & cardiomyopathies
Right ventricular to pulmonary artery coupling and clinical outcomes after interatrial shunting in heart failure: exploratory analysis of the PRELIEVE study
Authors' conclusion
In patients with HF undergoing interatrial shunting, impaired baseline RV-PA coupling assessed by a low TAPSE/PASP ratio was associated with higher rates of CV death or recurrent HF hospitalizations. The potential value of baseline RV-PA uncoupling in identifying responders to LA shunt therapies requires prospective evaluation in adequately powered prospective studies.
Study context
- Population
- Patients with symptomatic heart failure (HF) (reduced and preserved ejection fraction) undergoing atrial flow regulator (AFR) implantation, followed for 12 monthspatients with symptomatic HF who underwent AFR implantation · reduced ejection fraction 62 · preserved ejection fraction 44
- Participants
- 106 patients
- Comparison
- Baseline RV-PA coupling and outcomes after AFR implantation
- Primary endpoint
- cardiovascular (CV) death or HF hospitalization (HFH)
- Follow-up
- 12 months
Methodological detailsexploratory analysis
- Exploratory analysis
Primary result
As reported in the abstract
- Patients who experienced the composite endpoint
- 19 patients (18%)
- Kaplan-Meier analysis: lowest tricuspid annular plane systolic excursion (TAPSE)/pulmonary artery systolic pressure (PASP) ratio tended to show the worst outcome
- P = .07
Further findings
Baseline NT-proBNP, patients with vs without the composite endpoint
| Outcome | Incidence rate ratio (95% CI) | P value | |
|---|---|---|---|
| Cumulative incidence of HFHs (recurrent-event Poisson regression) | 2.4 (1.0–5.6) | P = 0.039 | |
| 0.20.5125Incidence rate ratio (log scale) |
| Outcome | With composite endpoint | Without composite endpoint |
|---|---|---|
| Baseline TAPSE/PASP, patients with vs without the composite endpoint | 0.43 (as printed 0.33–0.53) | 0.53 (as printed 0.43–0.76) |
- Baseline NT-proBNP, patients with vs without the composite endpoint: P = .009
- Baseline TAPSE/PASP, patients with vs without the composite endpoint: P = .04
- Cumulative incidence of HF hospitalization (HFHs) (recurrent-event Poisson regression): lower baseline TAPSE/PASP associated with higher cumulative incidence of HFHs
Original publication
Right ventricular to pulmonary artery coupling and clinical outcomes after interatrial shunting in heart failure: exploratory analysis of the PRELIEVE study. ESC Heart Fail. Published 27 June 2026. doi:10.
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