Prognostic Value of Non-Invasively Determined Right Ventricular–Arterial Coupling Surrogate Parameters in Patients with Dilated Cardiomyopathy

TL;DR

This study shows that non-invasive echocardiography measurements can predict rehospitalization risk in patients with dilated cardiomyopathy.

Contribution

The study identifies RVFWLS/PASP and RVEF/PASP as novel independent predictors of rehospitalization in DCM patients.

Findings

RVFWLS/PASP and RVEF/PASP were independent predictors of rehospitalization in multivariate analysis.

Optimal cut-offs for RVEF/PASP and RVFWLS/PASP showed high sensitivity and specificity for rehospitalization risk.

No significant correlation was found between the parameters and all-cause mortality.

Abstract

Background/Objectives: Right ventricular dysfunction is frequent in patients with dilated cardiomyopathy (DCM) and contributes significantly to prognosis. This study evaluated the prognostic value of echocardiography-determined surrogate parameters of right ventricular–arterial (RV–PA) coupling in patients with DCM. Methods: A total of 88 patients admitted between January 2019 to September 2023 were retrospectively and prospectively assessed and followed for a mean of 14 months. The primary endpoint was rehospitalization for decompensated heart failure (HF); the secondary endpoint was all-cause mortality. The parameters studied included TAPSE/PASP, RVFAC/PASP, RVFWLS/PASP, and RVEF/PASP. Results: In univariate analysis, all indices were associated with rehospitalization, but multivariate analysis retained only RVFWLS/PASP and RVEF/PASP as independent predictors. Optimal cut-offs were identified as 1.2 for RVEF/PASP (sensitivity 72%, specificity 80%) and 0.46 for RVFWLS/PASP (sensitivity 72%, specificity 76%). None of the parameters correlated significantly with all-cause mortality. Conclusions: These findings highlight the prognostic utility of non-invasively derived RV–PA coupling indices for rehospitalization risk stratification in DCM.

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