Noninvasive assessment of disproportionate right to left ventricular filling pressure in patients with heart failure
INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, vol.42, no.2, pp.215-223, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 42 Issue: 2
- Publication Date: 2026
- Doi Number: 10.1007/s10554-025-03562-z
- Journal Name: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Page Numbers: pp.215-223
- Keywords: Heart failure, Echocardiography, Prognosis, Right atrial pressure, Left atrial pressure
- Dokuz Eylül University Affiliated: No
Abstract
Disproportionate right and left ventricular filling pressures, as measured using right atrial to wedge pressure (RA/WP) is a marker of right heart failure and worse outcomes in patients with heart failure (HF), but an invasive hemodynamic study is needed to measure RA/WP. Using echocardiography, an estimation of RA/WP (eRA/WP) could be calculated non-invasively. The aim of the present study was to understand the feasibility and usefulness of eRA/WP in the general HF population where invasive assessment is not routinely done. Estimated RA/WP was calculated using mitral E velocity, lateral and septal tissue Doppler velocities and inferior vena cava diameter. A second dataset obtained from patients undergoing cardiac catheterization was used to determine agreement between eRA/WP and catheter-derived RA/WP. Estimated RA/WP showed significant correlations with right atrial area (r = 0.27,p < 0.001), right ventricular diameter (r = 0.20,p = 0.006), right ventricular fractional area change (r=-0.19,p = 0.01) and systolic pulmonary artery pressure (r = 0.44,p < 0.001). Being in the highest quartile was significantly associated with the primary composite endpoint at 180 days in unadjusted (OR:2.28,95%CI:1.20-4.36,p = 0.012) and adjusted (OR:2.59,95%CI:1.26-5.31, p = 0.009) models. Intraclass correlation coefficients for agreement between eRA/WP and catheter-based RA/WP was 0.72 for single measures and 0.84 for average measures. Assessment of disproportionate right to left ventricular filling pressures using echocardiographic estimation of RA/WP is feasible and useful to predict short-term prognosis in HF patients. [GRAPHICS]