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For: Anastasiou V, Papazoglou AS, Moysidis DV, Daios S, Barmpagiannos K, Gossios T, Efthimiadis GK, Karamitsos T, Ziakas A, Kamperidis V. The prognostic impact of right ventricular-pulmonary arterial coupling in heart failure: a systematic review and meta-analysis. Heart Fail Rev 2024;29:13-26. [PMID: 37639067 PMCID: PMC10904417 DOI: 10.1007/s10741-023-10341-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 08/29/2023]

For:	Anastasiou V, Papazoglou AS, Moysidis DV, Daios S, Barmpagiannos K, Gossios T, Efthimiadis GK, Karamitsos T, Ziakas A, Kamperidis V. The prognostic impact of right ventricular-pulmonary arterial coupling in heart failure: a systematic review and meta-analysis. Heart Fail Rev 2024;29:13-26. [PMID: 37639067 PMCID: PMC10904417 DOI: 10.1007/s10741-023-10341-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2023] [Indexed: 08/29/2023]

Number

Cited by Other Article(s)

Bowcock E, Huang S, Yeo R, Walisundara D, Duncan CF, Pathan F, Strange G, Playford D, Orde S. The value of right ventricular to pulmonary arterial coupling in the critically ill: a National Echocardiography Database of Australia (NEDA) substudy. Ann Intensive Care 2024;14:10. [PMID: 38228991 DOI: 10.1186/s13613-024-01242-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/02/2024] [Indexed: 01/18/2024] Open

Abstract

BACKGROUND

Right ventricular (RV) function is tightly coupled to afterload, yet echocardiographic indices of RV function are frequently assessed in isolation. Normalizing RV function for afterload (RV-PA coupling) using a simplified ratio of tricuspid annular plane systolic excursion (TAPSE)/ tricuspid regurgitant velocity (TRV) could help to identify RV decompensation and improve risk stratification in critically ill patients. This is the first study to explore the distribution of TAPSE/TRV ratio and its prognostic relevance in a large general critical care cohort.

METHODS

We undertook retrospective analysis of echocardiographic, clinical, and mortality data of intensive care unit (ICU) patients between January 2012 and May 2017. A total of 1077 patients were included and stratified into tertile groups based on TAPSE/TRV ratio: low (< 5.9 mm.(m/s)-1), middle (≥ 5.9-8.02 mm.(m/s)-1), and high (≥ 8.03 mm.(m/s)-1). The distribution of the TAPSE/TRV ratio across ventricular function subtypes of normal, isolated left ventricular (LV), isolated RV, and biventricular dysfunction was explored. The overall prognostic relevance of the TAPSE/TRV ratio was tested, including distribution across septic, cardiovascular, respiratory, and neurological subgroups.

RESULTS

Higher proportions of ventricular dysfunctions were seen in low TAPSE/TRV tertiles. TAPSE/TRV ratio is impacted by LV systolic function but to a lesser extent than RV dysfunction or biventricular dysfunction. There was a strong inverse relationship between TAPSE/TRV ratio and survival. After multivariate analysis, higher TAPSE/TRV ratios (indicating better RV-PA coupling) were independently associated with lower risk of death in ICU (HR 0.927 [0.872-0.985], p < 0.05). Kaplan-Meier analysis demonstrated higher overall survival in middle and high tertiles compared to low tertiles (log rank p < 0.0001). The prognostic relevance of TAPSE/TRV ratio was strongest in respiratory and sepsis subgroups. Patients with TAPSE/TRV < 5.9 mm (m/s)-1 had a significantly worse prognosis than those with higher TAPSE/TRV ratios.

CONCLUSION

The TAPSE/TRV ratio has prognostic relevance in critically ill patients. The prognostic power may be stronger in respiratory and septic subgroups. Larger prospective studies are needed to investigate the role of TAPSE/TRV in pre-specified subgroups including its role in clinical decision-making.

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Alcidi G, Pugliese R, Ioannoni S, Romano M, Palmieri G, Tabella E, Correale M, Di Biase M, Brunetti ND, Iacoviello M. Improvement in Left and Right Ventricular Function after Introduction of SGLT2 Inhibitors in Heart Failure Outpatients with Reduced Ejection Fraction. Clin Pract 2023;13:1303-1312. [PMID: 37987417 PMCID: PMC10660544 DOI: 10.3390/clinpract13060116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 11/22/2023] Open

Affiliation(s)

Gianmarco Alcidi School of Cardiology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.A.); (R.P.); (S.I.); (M.R.); (G.P.); (E.T.); (M.D.B.); (N.D.B.)
Rosanna Pugliese School of Cardiology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.A.); (R.P.); (S.I.); (M.R.); (G.P.); (E.T.); (M.D.B.); (N.D.B.)
Sara Ioannoni School of Cardiology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.A.); (R.P.); (S.I.); (M.R.); (G.P.); (E.T.); (M.D.B.); (N.D.B.)
Matteo Romano School of Cardiology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.A.); (R.P.); (S.I.); (M.R.); (G.P.); (E.T.); (M.D.B.); (N.D.B.)
Gianpaolo Palmieri School of Cardiology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.A.); (R.P.); (S.I.); (M.R.); (G.P.); (E.T.); (M.D.B.); (N.D.B.)
Erika Tabella School of Cardiology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.A.); (R.P.); (S.I.); (M.R.); (G.P.); (E.T.); (M.D.B.); (N.D.B.)
Michele Correale Cardiology Unit, University Polyclinic Hospital of Foggia, 71122 Foggia, Italy;
Matteo Di Biase School of Cardiology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.A.); (R.P.); (S.I.); (M.R.); (G.P.); (E.T.); (M.D.B.); (N.D.B.)
Natale Daniele Brunetti School of Cardiology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.A.); (R.P.); (S.I.); (M.R.); (G.P.); (E.T.); (M.D.B.); (N.D.B.) Cardiology Unit, University Polyclinic Hospital of Foggia, 71122 Foggia, Italy;
Massimo Iacoviello School of Cardiology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy; (G.A.); (R.P.); (S.I.); (M.R.); (G.P.); (E.T.); (M.D.B.); (N.D.B.) Cardiology Unit, University Polyclinic Hospital of Foggia, 71122 Foggia, Italy;

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