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Beyls C, Yakoub-Agha M, Hermida A, Martin N, Crombet M, Hanquiez T, Fournier A, Jarry G, Malaquin D, Michaud A, Abou-Arab O, Leborgne L, Mahjoub Y. Prognostic Value of a New Right Ventricular-to-Pulmonary Artery Coupling Parameter Using Right Ventricular Longitudinal Shortening Fraction in Patients Undergoing Transcatheter Aortic Valve Replacement: A Prospective Echocardiography Study. J Clin Med 2024; 13:1006. [PMID: 38398319 PMCID: PMC10889072 DOI: 10.3390/jcm13041006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Introduction: Right-ventricular-to-pulmonary artery (RV-PA) coupling, measured as the ratio of tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP), has emerged as a predictor factor in patients undergoing transcatheter aortic valvular replacement (TAVR). Right ventricular longitudinal shortening fraction (RV-LSF) outperformed TAPSE as a prognostic parameter in several diseases. We aimed to compare the prognostic ability of two RV-PA coupling parameters (TAPSE/PASP and the RV-LSF/PASP ratio) in identifying MACE occurrences. Method: A prospective and single-center study involving 197 patients who underwent TAVR was conducted. MACE (heart failure, myocardial infarction, stroke, and death within six months) constituted the primary outcome. ROC curve analysis determined cutoff values for RV-PA ratios. Multivariable Cox regression analysis explored the association between RV-PA ratios and MACE. Results: Forty-six patients (23%) experienced the primary outcome. No significant difference in ROC curve analysis was found (RV-LSF/PASP with AUC = 0.67, 95%CI = [0.58-0.77] vs. TAPSE/PASP with AUC = 0.62, 95%CI = [0.49-0.69]; p = 0.16). RV-LSF/PASP < 0.30%.mmHg-1 was independently associated with the primary outcome. The 6-month cumulative risk of MACE was 59% (95%CI = [38-74]) for patients with RV-LSF/PASP < 0.30%.mmHg-1 and 17% (95%CI = [12-23]) for those with RV-LSF/PASP ≥ 0.30%.mmHg-1; (p < 0.0001). Conclusions: In a contemporary cohort of patients undergoing TAVR, RV-PA uncoupling defined by an RV-LSF/PASP < 0.30%.mmHg-1 was associated with MACE at 6 months.
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Affiliation(s)
- Christophe Beyls
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (M.Y.-A.); (M.C.); (O.A.-A.); (Y.M.)
- UR UPJV 758 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80054 Amiens, France
| | - Mathilde Yakoub-Agha
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (M.Y.-A.); (M.C.); (O.A.-A.); (Y.M.)
| | - Alexis Hermida
- Rythmology Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France;
| | - Nicolas Martin
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Maxime Crombet
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (M.Y.-A.); (M.C.); (O.A.-A.); (Y.M.)
| | - Thomas Hanquiez
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Alexandre Fournier
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Geneviève Jarry
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Dorothée Malaquin
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Audrey Michaud
- Biostatistics Unit, Clinical Research and Innovation Directorate, Amiens-Picardie University Hospital Centre, F-80054 Amiens, France
| | - Osama Abou-Arab
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (M.Y.-A.); (M.C.); (O.A.-A.); (Y.M.)
| | - Laurent Leborgne
- Cardiac Intensive Care Unit, Department of Cardiology, Amiens University Hospital, F-80054 Amiens, France; (N.M.); (T.H.); jarry.geneviè (D.M.); (L.L.)
| | - Yazine Mahjoub
- Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, F-80054 Amiens, France; (M.Y.-A.); (M.C.); (O.A.-A.); (Y.M.)
- UR UPJV 758 SSPC (Simplification of Care of Complex Surgical Patients) Research Unit, University of Picardie Jules Verne, F-80054 Amiens, France
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Fatima S, Jang S, Harinstein ME. Importance Of Assessing Right Ventricular Systolic Function in Patients Presenting With ST-Elevation Myocardial Infarction. Am J Cardiol 2024; 211:367-368. [PMID: 37980998 DOI: 10.1016/j.amjcard.2023.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/21/2023]
Affiliation(s)
- Shumail Fatima
- Division of Hospital Medicine, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Sae Jang
- Division of Cardiology, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Matthew E Harinstein
- Division of Cardiology, Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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