Right ventricular dysfunction in heart failure with preserved ejection fraction: a systematic review and meta-analysis.

Abstract:

AIMS:Right ventricular (RV) dysfunction and pulmonary hypertension (PH) are increasingly recognized in heart failure with preserved ejection fraction (HFpEF). The prevalence and prognostic value of RV dysfunction in HFpEF have been widely but variably reported. We therefore conducted a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. METHODS AND RESULTS:English literature until May 2016 was evaluated for prevalence of RV dysfunction [i.e. tricuspid annular plane systolic excursion (TAPSE) <16 mm, fractional area change (FAC) <35%, or tricuspid annular systolic velocity (RV S') <9.5 cm/s)] and PH [i.e. mean pulmonary artery pressure (MPAP) ≥25 mmHg or pulmonary artery systolic pressure (PASP) ≥35 mmHg]. Combined hazard ratios (HRs) for outcomes were calculated. A total of 38 studies was included. In studies with stringent HFpEF criteria, prevalence of RV dysfunction was 28% for TAPSE, 18% for FAC, and 21% for RV S'. Prevalence of PH was 68% for both increased MPAP and PASP. TAPSE (HR 1.26/5 mm decrease; P < 0.0001), FAC (HR 1.15/5% decrease; P < 0.0001), MPAP (HR 1.26/5 mmHg increase; P < 0.0001), and PASP (1.16/5 mmHg increase; P < 0.0001) were all univariably associated with mortality. HRs for RV S' were not reported. CONCLUSION:RV dysfunction and PH are highly prevalent and are both associated with poor outcome in patients with HFpEF.

journal_name

Eur J Heart Fail

authors

Gorter TM,Hoendermis ES,van Veldhuisen DJ,Voors AA,Lam CS,Geelhoed B,Willems TP,van Melle JP

doi

10.1002/ejhf.630

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

1472-1487

issue

12

eissn

1388-9842

issn

1879-0844

journal_volume

18

pub_type

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