• Massimo Iacoviello, Francesco Monitillo, Gaetano Citarelli, Marta Leone, Dario Grande, Valeria Antoncecchi, Caterina Rizzo, Paola Terlizzese, Roberta Romito, Pasquale Caldarola, and Marco Matteo Ciccone.
• Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Bari, Italy.. Electronic address: massimo.iacoviello@policlinico.ba.it.
• Int. J. Cardiol. 2017 Aug 15; 241: 318-321.

Aim Of The StudyTo evaluate whether right ventriculo-arterial coupling obtained by the estimation of the two-dimensional right ventricular (RV) longitudinal strain and of the pulmonary arterial systolic pressure (PASP) could improve prognostic stratification of chronic heart failure (CHF) outpatients.MethodsCHF outpatients in a stable clinical condition and in conventional therapy were enrolled. The global RV longitudinal strain (RV-GLS) and the strain of the RV free wall (RV-fwLS) were evaluated. PASP was estimated on the basis of tricuspid regurgitation velocity and the estimated central venous pressure. Both RV-GLS and RV-fwLS were then indexed for PASP.ResultsOf the 315 patients evaluated, 69 died during follow-up. Both RV-GLS/PASP and RV-fwLS/PASP were significantly associated with an increased risk of death at univariate (HR: 0.43; 95%CI: 0.34-0.56; p<0.001 and HR: 0.44; 95% CI: 0.34-0.57; p<0.001, respectively) and multivariate analysis (HR: 0.66; 95% CI: 0.49-0.89; p: 0.008 and HR: 0.65; 95% CI: 0.49-0.85; p: 0.002, respectively) after correction for age, NYHA class, mean arterial pressure, left ventricular ejection fraction, natremia, glomerular filtration rate and NT-proBNP.ConclusionsIndexing RV function, assessed by speckle-tracking analysis, with an estimation of pulmonary systolic arterial pressure provides a parameter of ventricular arterial coupling that is independently associated with an increased risk of mortality.Copyright © 2017 Elsevier B.V. All rights reserved.

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