Gender and Age Differences in Right Ventricular to Pulmonary Arterial Coupling in Healthy Subjects - Knowing the Norm to Spot the Disease

• Published in: The American journal of cardiology Vol. 197; pp. 84 - 86
• Main Authors: Fortuni, Federico, Delgado, Victoria
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 15.06.2023; Elsevier Limited
• Subjects: Age differences; Cardiovascular disease; Cardiovascular diseases; Confidence intervals; Congestive heart failure; Coupling; Gender differences; Healthy Volunteers; Heart failure; Heart Ventricles - diagnostic imaging; Humans; Hypertension; Hypertension, Pulmonary; Mortality; Muscle contraction; Prognosis; Pulmonary arteries; Pulmonary Artery - diagnostic imaging; Pulmonary hypertension; Signs and symptoms; Ventricle; Ventricular Dysfunction, Right; Ventricular Function, Right; Womens health
• ISSN: 0002-9149; 1879-1913; 1879-1913
• DOI: 10.1016/j.amjcard.2023.03.032

[...]whereas TAPSE/PASP showed an independent association with both NT-proBNP and 6MWD, TAPSE was not associated with NT-proBNP, and PASP did not show an association with 6MWD.9 This may highlight the importance of integrating RV contractility (with the use of TAPSE) and afterload (with the use of PASP) when assessing RV function. [...]prospective studies would be needed to investigate whether TAPSE/PASP deteriorates sooner compared with other indices of RV systolic function in patients developing cardiovascular disease. [...]it would be interesting also to know whether TAPSE/PASP has a prognostic value also in healthy subjects and whether cardiovascular medications have an effect on RV-PA coupling that impacts prognosis and prevents the development of HF symptoms. [...]new echocardiographic indices of RV-PA coupling based on more advanced parameters such as the ratio between RV free wall strain and PASP10 and also RV myocardial work indices11,12 have been proposed and showed an association with prognosis in mitral regurgitation10 and pulmonary hypertension.12 Nevertheless, differently from TAPSE/PASP, these new indices have not yet been validated against the invasive gold standard assessment of RV-PA coupling (i.e., invasive pressure-volume loop-derived RV end-systolic/PA elastance ratio) and further studies would be needed together with the derivation of normal cut-off values in healthy subjects.Disclosures Victoria Delgado received speaker fees from Edwards Lifesciences, Medtronic, Novartis, and Philips, and consulting fees from Edwards Lifesciences and Novo Nordisk (heart failure).