Prognostic power of a new index of right ventricle-pulmonary artery coupling based on right ventricular volumes in patients with secondary tricuspid regurgitation

Abstract Background Although echocardiographic surrogates of right ventricular -arterial coupling (RVAC) have been reported to be associated with outcome in patients moderate or severe secondary tricuspid regurgitation (STR), pulmonary artery systolic pressure (SPAP) is difficult estimated using echocardiography STR. Purpose Accordingly, we evaluated the predictive power indexes RVAC obtained RV volumes measured three-dimensional (3DE). Methods We prospectively enrolled 180 STR and complete two-dimensional, Doppler 3DE data. The composite endpoint death for any cause heart failure hospitalization was used as primary outcome. Results After a median follow up 24 months (IQR: 2–48), 72 (40%) reached endpoint. Most parameters function were outcomes. Among different RVAC, receiver operating curve (ROC) analysis selected ratio between (RV stroke volume [SV]-RegVol)/ End-systolic (ESV) (i.e. forward SV/ESV) best predictor combined (AUC 0.80 [IC 95% 0.73–087]), threshold value 0.49. Event-free survival SV/ESV higher lower 0.49 has performed (Figure 1). Multivariable Cox proportional hazards models constructed 2). Adding sequentially 3D-RVEF, TAPSE/SPAP SV/RV ESV on top basal model made TR severity, New York Heart Association (NYHA) functional class anulus plane excursion (TAPSE), χ2 increased from 40 43 (p=0.13) by adding 3D RVEF, 46 (p=0.04) TAPSE/SPAP, 51 (p=0.02) SV/ESV. Severe (HR 3.53 [CI 95%: 1.84–6.78], p<0.001) <0.49 2.45 1.16–5.18], p=0.02) only independently Conclusions an index which independent SPAP it strongly occurrence Funding Acknowledgement Type funding sources: None.