A weaker right heart may signal trouble after a common heart failure procedure. A new study found that heart failure patients with lower right ventricular-pulmonary artery (RV-PA) coupling — measured by the TAPSE/PASP ratio — faced nearly four times the risk of cardiovascular death or rehospitalization after interatrial shunt device implantation. The findings suggest this simple echocardiographic marker could help identify patients unlikely to benefit from the procedure.
A weaker right heart may signal trouble after a common heart failure procedure. Researchers analyzing data from the PRELIEVE pilot study found that heart failure patients with lower right ventricular-pulmonary artery (RV-PA) coupling — estimated via the TAPSE/PASP ratio on echocardiography — had significantly worse outcomes 12 months after receiving an interatrial shunt device. The study included 106 patients across 15 sites in Germany, Turkey, and Belgium.
Patients in the lowest TAPSE/PASP tertile faced nearly four times the rate of recurrent cardiovascular events compared to those in the highest tertile, suggesting that impaired RV-PA coupling may identify "non-responders" to left atrial decompression therapy. Notably, patients who stayed event-free showed improvement in their coupling ratio at 3 months, while those who experienced events did not.
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Why it matters: This research points to a straightforward, non-invasive echocardiographic measure that could help clinicians better select heart failure patients for interatrial shunting — potentially avoiding a costly procedure in those least likely to benefit.
