Right ventricle – pulmonary artery coupling is a risk factor for mortality in patients with pulmonary hypertension associated with heart failure and preserved ejection fraction

Background: Pulmonary hypertension (PH), which is related to right ventricular (RV) failure, indicates a poor prognosis in heart failure (HF). RV-pulmonary artery coupling (RVPAC) may detect early RV dysfunction. Aim: To assess the association between RVPAC and mortality in Patients with PH associated with HF Methods: Patients with HF and systolic pulmonary artery pressure>40 mmHg on echocardiography were included in the study. Cox proportional hazard regression models were used to assess the association between RVPAC and mortality Results: 609 patients were included in the study. The average age was 71±13.2 years and 301 were female. 208 patients had HF with reduced ejection fraction (HFrEF), and 401 had HF with preserved EF (HFpEF). Low RVPAC was found to significantly increased the risk of mortality (P<0.038). However, when we evaluate the risk for mortality in the HFpEF group as opposed to the HFrEF group, RVPAC was found to be an independent predictor of mortality only in patients with HFpEF (P<0.001) Conclusion: RVPAC is an independent risk factor for mortality in patients with PH associated with HFpEF but not HFrEF.