Study finds right ventricular dysfunction in 42% of HFpEF patients
A retrospective study of 163 HFpEF patients linked right ventricular dysfunction to higher NT-proBNP and several echocardiographic measures.
By Tom Brennan · Health & Medicine Correspondent
2 min read
Right ventricular dysfunction appeared in 41.7% of patients with heart failure with preserved ejection fraction in a retrospective cohort study published June 10 in BMC Cardiovascular Disorders. The finding suggests that impaired right ventricular function is common in this HFpEF population and may be identifiable through a combined assessment of echocardiography and NT-proBNP, according to the researchers.
Xin Du of Xiamen Humanity Hospital in China and colleagues reviewed 163 patients diagnosed with HFpEF from January 2022 through January 2024. The research team evaluated right ventricular function in every patient included in the analysis.
The study classified patients as having right ventricular dysfunction if they had a tricuspid annular plane systolic excursion, or TAPSE, below 17 mm, or an absolute right ventricular free wall strain, known as RV-FWS, under 20%. By those criteria, 41.7% of the cohort met the definition for right ventricular dysfunction, the authors reported.
Blood marker and imaging findings
Patients in the right ventricular dysfunction group had substantially higher N-terminal pro-B-type natriuretic peptide levels, according to Du and colleagues. NT-proBNP is the blood marker evaluated in the study alongside echocardiographic measures.
The researchers found that several echocardiographic variables independently predicted right ventricular dysfunction in the HFpEF cohort. Those measures included RV-FWS, systolic pulmonary artery pressure, the mean ratio of early mitral inflow velocity to early diastolic mitral annular velocity, left atrial volume index, TAPSE and fractional area change.
Among individual measurements, RV-FWS had the strongest predictive performance, the study authors reported. A model that combined all six echocardiographic parameters showed excellent ability to distinguish patients with right ventricular dysfunction from those without it.
After internal validation using a bootstrap method, the combined model had a corrected area under the receiver operating characteristic curve of 0.989, according to the study. The authors presented that result as evidence that a multiparameter echocardiographic approach may improve detection of right ventricular dysfunction in patients with HFpEF.
Authors call for integrated evaluation
Du and colleagues wrote that pairing multiple echocardiographic measures with NT-proBNP assessment improved early detection and risk stratification of right ventricular dysfunction. They said routine use of that integrated strategy in HFpEF management could help identify affected patients earlier and support more targeted intervention.
The study was retrospective and based on patients from a single time period, as described by the authors. The findings were reported in BMC Cardiovascular Disorders under the title “Prevalence of right ventricular dysfunction and its echocardiographic predictors in patients with heart failure with preserved ejection fraction: a retrospective cohort study.”
This story draws on original reporting from Medical Xpress.