Introduction. Pulmonary hypertension (PH) and right ventricular dysfunction (RVD) have a significant negative impact on the prognosis of patients with heart failure (HF), but their clinical implications on HF hospitalizations after myocardial revascularization remains insufficiently elucidated.
The objective of the study was to assess the prognostic impact of PH and RVD on the risk of HF hospitalizations during the first year after myocardial revascularization.
Material and methods. The prospective study included 275 patients with ischemic HF who underwent myocardial revascularization and were divided into two groups: HF hospitalization (+) and HF hospitalization (-). The clinical examination, echocardiography and laboratory tests were performed in all patients. The follow up period was 12 months.
Results. The HF hospitalization rate was 18.1%. In the HF hospitalization (+) group, the percentage of patients with high probability of PH (56.0% vs. 26.7%) and RVD (70.0% vs 32.4%) was higher. The most relevant prognostic factors were RVD, along with tricuspid annular plane systolic excursion (TAPSE), right ventricular (RV) fractional area change, systolic velocity of the lateral tricuspid valve annulus, RV index of myocardial performance, RV end-diastolic diameter, the ratio between TAPSE and pulmonary artery systolic pressure, high echocardiographic probability of PH, peak tricuspid regurgitation velocity. A prediction model for HF hospitalizations during the first year after myocardial revascularization was developed (AUC=0.827).
Conclusions. The echocardiographic parameters suggestive of PH and RVD proved to be relevant prognostic factors for HF hospitalizations in the first year after myocardial revascularization. In this context, a predictive model with good discriminatory performance was developed.
Keywords: pulmonary hypertension, right ventricular dysfunction, heart failure hospitalizations, prognosis, myocardial revascularization.
Full text sources https://doi.org/10.31688/ABMU.2025.60.1.03
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