Table 3.
Correlates of the development of right ventricular dysfunction
| Development of RV dysfunction |
P-value | OR (95% CI) | P-value | ||
|---|---|---|---|---|---|
| No (n = 183) | Yes (n = 55) | ||||
| Age (years) | 71 ± 10 | 71 ± 9 | 0.9 | 1.01 (0.74–1.36) | 0.9 |
| Female, n (%) | 112 (61) | 26 (47) | 0.1 | 0.57 (0.31–1.05) | 0.1 |
| Body mass index (kg/m2) | 32 ± 7 | 34 ± 7 | 0.1 | 1.27 (0.95–1.71) | 0.1 |
| Body weight (kg) | 89 ± 21 | 98 ± 25 | 0.02 | 1.46 (1.07–1.93) | 0.01 |
| Comorbidities, n (%) | |||||
| Diabetes mellitus | 53 (29) | 24 (44) | 0.04 | 1.88 (1.01–3.51) | 0.04 |
| Hypertension | 157 (86) | 45 (82) | 0.5 | 0.75 (0.33–1.66) | 0.5 |
| Prevalent AF at Exam 1 | 57 (31) | 31 (56) | 0.0007 | 2.86 (1.54–5.30) | 0.0009 |
| Incident persistent AF (n = 155/37)a | 33 (21) | 16 (43) | 0.006 | 2.82 (1.32–6.00) | 0.007 |
| Coronary artery disease | 96 (52) | 38 (69) | 0.03 | 2.03 (1.07–3.85) | 0.03 |
| Pacemaker | 23 (13) | 9 (16) | 0.5 | 1.36 (0.59–3.14) | 0.5 |
| Medications, n (%) | |||||
| ACEI or ARB | 103 (56) | 37 (67) | 0.1 | 1.60 (0.85–3.01) | 0.1 |
| Beta-blocker | 118 (64) | 40 (73) | 0.3 | 1.47 (0.75–2.86) | 0.3 |
| Calcium channel blocker | 57 (31) | 21 (38) | 0.3 | 1.37 (0.73–2.56) | 0.3 |
| Loop diuretic | 63 (34) | 28 (51) | 0.03 | 1.98 (1.07–3.64) | 0.03 |
| Aldosterone antagonist | 19 (10) | 4 (7) | 0.5 | 0.68 (0.22–2.08) | 0.5 |
| Laboratories | |||||
| Haemoglobin (g/dL) | 12.3 ± 1.7 | 12.5 ± 1.5 | 0.5 | 1.12 (0.82–1.52) | 0.5 |
| Creatinine (mg/dL) | 1.2 ± 0.4 | 1.2 ± 0.4 | 0.4 | 1.13 (0.85–1.50) | 0.4 |
| Haemodynamics | |||||
| Systolic BP (mmHg) | 133 ± 21 | 134 ± 22 | 0.8 | 1.04 (0.76–1.40) | 0.8 |
| Diastolic BP (mmHg) | 71 ± 13 | 70 ± 11 | 0.9 | 0.98 (0.73–1.33) | 0.9 |
| Heart rate (b.p.m.) | 67 ± 12 | 63 ± 11 | 0.03 | 0.69 (0.49–0.98) | 0.04 |
| LV structure and function | |||||
| LV diastolic dimension (mm) | 49 ± 6 | 50 ± 5 | 0.03 | 1.39 (1.02–1.91) | 0.04 |
| LV mass index (g/m2) | 100 ± 29 | 111 ± 27 | 0.01 | 1.45 (1.06–1.92) | 0.01 |
| LV ejection fraction (%) | 62 ± 6 | 61 ± 7 | 0.4 | 0.87 (0.64–1.18) | 0.4 |
| Cardiac output (L/min) | 5.9 ± 1.5 | 5.8 ± 1.7 | 0.6 | 0.91 (0.67–1.24) | 0.6 |
| LA volume index (mL/m2) | 41 ± 14 | 46 ± 12 | 0.01 | 1.38 (1.03–1.88) | 0.03 |
| Mitral E-wave (cm/s) | 96 ± 31 | 103 ± 27 | 0.1 | 1.28 (0.95–1.72) | 0.1 |
| Mitral annular e′ (cm/s) | 6.4 ± 2.1 | 6.8 ± 2.5 | 0.3 | 1.18 (0.87–1.61) | 0.3 |
| E/e′ ratio | 16 ± 7 | 17 ± 8 | 0.4 | 1.14 (0.84–1.53) | 0.4 |
| Medial mitral annular s′ (cm/s) | 6.8 ± 2.2 | 6.4 ± 2.0 | 0.2 | 0.80 (0.57–1.13) | 0.2 |
| RV structure and function | |||||
| Right atrial area (cm2) | 15 ± 5 | 17 ± 6 | 0.003 | 1.55 (1.15–2.08) | 0.004 |
| RV basal dimension (mm) | 32 ± 7 | 36 ± 6 | <0.0001 | 2.10 (1.48–2.97) | <0.0001 |
| RV diastolic area (cm2) | 13 ± 4 | 16 ± 4 | <0.0001 | 2.01 (1.46–2.77) | <0.0001 |
| RV fractional area change (%) | 52 ± 6 | 48 ± 8 | 0.01 | 0.64 (0.46–0.87) | 0.005 |
| RVSP (mmHg) | 41 ± 13 | 48 ± 17 | 0.006 | 1.53 (1.15–2.13) | 0.002 |
| Moderate or severe TR (%) | 27 (15%) | 10 (18%) | 0.5 | 1.28 (0.58–2.85) | 0.5 |
| Invasive haemodynamics (n = 126) | |||||
| RA pressure (mmHg) | 9 ± 4 | 11 ± 4 | 0.03 | 1.57 (1.01–2.52) | 0.04 |
| PA systolic pressure (mmHg) | 42 ± 13 | 50 ± 20 | 0.01 | 1.68 (1.07–2.58) | 0.02 |
| PA mean pressure (mmHg) | 27 ± 8 | 32 ± 10 | 0.03 | 1.81 (1.15–2.80) | 0.01 |
| PCWP (mmHg) | 16 ± 5 | 20 ± 5 | 0.002 | 1.98 (1.25–3.29) | 0.004 |
| PVR (WU) | 2.3 ± 1.1 | 3.5 ± 3.9 | 0.3 | 1.54 (0.91–2.61) | 0.1 |
| PA compliance (mL/mmHg) | 3.5 ± 1.6 | 3.0 ± 1.4 | 0.2 | 0.68 (0.34–1.36) | 0.3 |
| TPG (mmHg) | 11 ± 5 | 13 ± 9 | 0.5 | 1.25 (0.82–1.91) | 0.3 |
ORs are expressed as per 1 SD increment.
ACEI, angiotensin-converting enzyme inhibitors; AF, atrial fibrillation; ARB, angiotensin-receptor blockers; BP, blood pressure; CI, confidential interval; E/e′, the ratio of early mitral diastolic inflow velocity to early diastolic mitral annular velocity; HFpEF, heart failure with preserved ejection fraction; LA, left atrial; LV, left ventricular; OR, odds ratio; PA, pulmonary artery; PCWP, pulmonary capillary wedge pressure; PVR, pulmonary vascular resistance; RA, right atrial; RV, right ventricular; RVSP, right ventricular systolic pressure; SD, standard deviation; TPG, transpulmonary gradient; TR, tricuspid regurgitation.
Analysed in HFpEF patients with sinus rhythm or paroxysmal atrial fibrillation at Exam 1.