Outcome in XXXX with Preserved Ejection Fraction: The Role of Myocardial Structure and Right Ventricular Performance.

@entity1 @entity64 @entity712 @entity204 @entity65
BACKGROUND: @entity712 with preserved ejection fraction (HFpEF) is recognized as a major cause of @entity65 and mortality. Thus, a profound understanding of the pathophysiologic changes in HFpEF is needed to identify risk factors and potential treatment targets in this specific @entity1 population. Therefore, we aimed to comprehensively assess the impact of left- and right-ventricular function and hemodynamics on long-term mortality and morbidity in order to improve risk prediction in @entity1 with HFpEF. METHODS AND RESULTS: We prospectively included 142 consecutive @entity1 with HFpEF into our observational, non-interventional registry. Echocardiography, cardiac magnetic resonance imaging and invasive hemodynamic assessments including myocardial biopsy were performed at baseline. We detected significant correlations between left ventricular extracellular matrix and left ventricular end-diastolic diameter (r = -0.64;p = 0.03) and @entity64 volume (r = -0.53;p = 0.04). Hospitalization for @entity712 and/or @entity204 was observed over a median follow up of 10 months. The strongest risk factors were reduced right ventricular function (adj. HR 6.62;95%CI 3.12- 14.02;p<0.001), systolic pulmonary arterial pressure (adj. HR per 1-SD 1.55;95%CI 1.15- 2.09;p = 0.004) and the pulmonary artery wedge pressure (adj. HR per 1-SD 1.51;95%CI 1.09-2.08; p = 0.012). The area under the ROC curve for right ventricular function was 0.63, for systolic pulmonary arterial pressure 0.75, and for pulmonary artery wedge pressure 0.68. CONCLUSION: The current study emphasizes the importance of right ventricular function and pulmonary pressures on outcome in @entity1 with HFpEF providing pathophysiological insights into the hemodynamic changes in HFpEF.
