Table 2. Selected studies assessing the prognostic value of metrics of ventriculo-arterial coupling or diastology in PAH and HFpEF.
| First author, journal, year | Number | RV metric | Study design | Link with outcomes |
|---|---|---|---|---|
| Pulmonary arterial hypertension | ||||
| Vanderpool et al. Heart, 2015 | 50 PH | Ees/Ea (single beat method); SV/ ESV (volumetric method) | Retrospective | SV/ESV >0.515 was associated with increased transplant-free survival. No association with survival was seen with Ees/Ea by the single beat method |
| Brewis et al. Int J Cardiol, 2016 | 84 PAH | Ees/Ea (single beat method); SV/ESV (volumetric method) | Retrospective | SV/ESV >0.534 was associated with increased transplant-free survival. No association with survival was seen with Ees/Ea by the single beat method |
| Vanderpool et al. Eur Respir J, 2017 | 33 PAH | Ees/Ea (single beat method); SV/ ESV (volumetric method) | Treatment-naïve patients with advanced PAH. Follow-up data after treatment with parenteral treprostinil | SV/ESV increased after therapy with parenteral treprostinil. No changes in Ees/Ea by the single beat method |
| Tello et al. Circulation: CV Imaging, 2019 | 52 PAH | TAPSE/sPAP | Prospective | TAPSE/sPAP <0.31 mm/mm Hg associated with worse prognosis. This cut-off had 87.5% sensitivity and 75.9% specificity for prediction of Ees/Ea <0.805 (single beat method) |
| Richter et al. AJRCCM, 2020 | 38 pre-capillary PH | Ees/Ea (multibeat method) | Prospective | Ees/Ea ≥0.70 was associated with a lower incidence of clinical worsening |
| Hsu et al. J Am Heart Assoc, 2020 | 26 PAH | Ees/Ea (multibeat method) | Retrospective | Ees/Ea >0.65 was associated with a lower incidence of clinical worsening. Ees/Ea >0.65 remained predictive of outcomes in the multivariate regression model |
| Heart failure with preserved ejection fraction | ||||
| Guazzi et al. Am J. Physiol - Hear Circ Physiol, 2013 | 334 patients with heart failure (13.8% with HFpEF) | TAPSE/sPAP | Retrospective | TAPSE/sPAP <0.36 was associated with increased cardiac-related mortality. Study not specific for PH |
| Gerges et al. AJRCCM, 2015 | 451 Group 2 PH | Ees/Ea (single beat method) | Retrospective | Ees/Ea was lower in patients with HFpEF and combined pre- and post-capillary PH, as compared with isolated post-capillary PH (1.17±0.27 vs. 1.45±0.29, P<0.05). No clinical outcomes related to coupling reported |
| Gorter el al. Eur Heart J Cardiovasc Imaging, 2018 | 102 HFpEF (76 with HFpEF-PH) | TAPSE/sPAP | Prospective | TAPSE/sPAP <0.36 was associated with increased all-cause mortality |
| Diastology | ||||
| Trip et al. Eur Respir J, 2015 | 63 PAH | Eed (single beat method) | Retrospective | Univariate hazard ratio for Eed was 2.24 [95% CI (1.05–4.80), P=0.037]. Eed >0.53 predictive of survival |
| Vanderpool et al. Eur Respir J, 2017 | 33 PAH | Eed (single beat method); β (single beat method) | Treatment-naïve patients with advanced PAH. Follow-up data after treatment with parenteral treprostinil | Therapy with parenteral treprostinil was associated with significant reductions in both Eed and β |
β, diastolic coefficient β; Ea, arterial elastance; Eed, end-diastolic elastance; Ees, end-systolic elastance; ESV, end-systolic volume; HFpEF, heart failure with preserved ejection fraction; PAH, pulmonary arterial hypertension; PH, pulmonary hypertension; sPAP, systolic pulmonary artery pressure; SV, stroke volume; TAPSE, tricuspid annular plane systolic excursion.