Prevalence of right ventricular dysfunction ~40% in heart failure with preserved ejection fraction
· Medical Xpressby Elana Gotkine
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Right ventricular dysfunction (RVD) is prevalent in 41.7% of patients with heart failure with preserved ejection fraction (HFpEF), according to a study published online June 10 in BMC Cardiovascular Disorders.
Xin Du, from Xiamen Humanity Hospital in China, and colleagues retrospectively analyzed 163 patients diagnosed with HFpEF between January 2022 and January 2024. Right ventricular function was assessed in all patients; the presence of a tricuspid annular plane systolic excursion (TAPSE) below 17 mm or a right ventricular free wall strain (RV-FWS) absolute value under 20% characterized RVD.
The researchers found that the prevalence of RVD was 41.7% among the 163 patients. Substantially higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels characterized the RVD group. Occurrence of RVD was independently predicted by echocardiographic measures, including RV-FWS, systolic pulmonary artery pressure, mean ratio of early mitral inflow velocity to early diastolic mitral annular velocity, left atrial volume index, TAPSE, and fractional area change.
RV-FWS showed the best predictive performance among individual parameters. Excellent discriminatory ability was seen in a combined predictive model incorporating these six parameters. The corrected area under the receiver operating characteristic curve was 0.989 after internal validation using the bootstrap method.
"A multiparametric echocardiographic approach combined with NT-proBNP assessment significantly improved early detection and risk stratification of RVD," the authors write. "Routine implementation of this integrated evaluation strategy in the management of HFpEF may facilitate early identification and precision intervention, ultimately improving patient outcomes."
More information
Xin Du et al, Prevalence of right ventricular dysfunction and its echocardiographic predictors in patients with heart failure with preserved ejection fraction: a retrospective cohort study, BMC Cardiovascular Disorders (2026). DOI: 10.1186/s12872-026-06093-0
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