Strain-based right ventricular-pulmonary arterial coupling: Association with long-term mortality in pre-capillary pulmonary hypertension

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Pre-capillary pulmonary hypertension (PH) is a progressive pulmonary vascular disorder with elevated mortality risk due to right ventricular (RV) failure. RV free wall strain (RVFWS) has been found to predict mortality in the short-term. Objectives - in a cohort of 575 patients with known or suspected pre-capillary PH: 1) to evaluate the association between RVFWS and mortality over 10 years; 2) to assess the value of repeat RVFWS in longitudinal follow-up, and 3) to test the incremental value of indexing RVFWS to PA pressure as an index of RV-PA coupling. Results: RVFWS & strain-based coupling index was associated with a higher risk of death (Figure) over 10 years of follow-up and on serial echo & was more strongly associated with mortality than either pulmonary pressures, TAPSE or TAPSE/RVSP. erj;66/suppl_69/PA6151/F1 F1 F1 Conclusions: Both RVFWS and a strain-based index of RV-PA coupling are strongly associated with patient outcomes over 10 years of follow-up. Changes in both RVFWS and strain-based RV-PA coupling index are also associated with outcome. Hence both may serve as useful baseline and serial echo-based markers of patient-specific risk in in patients with known or suspected pre-capillary PH.

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