ArticleCirculation. Heart failure2022
Right Ventricular and Right Atrial Function Are Less Compromised in Pulmonary Hypertension Secondary to Heart Failure With Preserved Ejection Fraction: A Comparison With Pulmonary Arterial Hypertension With Similar Pressure Overload.
Article in Circulation. Heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Prevalence of Pulmonary Hypertension in Individuals With Heart Failure: A Systematic Review and Meta-Analysis.Clinical cardiology · 2025Pooled it
- Heart-Lung Interactions in Pulmonary Hypertension due to Heart Failure With Preserved Ejection Fraction.Comprehensive physiology · 2026Review
- Relationship of cardiac MRI-derived pulmonary arterial stiffness markers and invasive hemodynamic.The international journal of cardiovascular imaging · 2026Article
- Quantitative CT Pulmonary Angiography and Echo Cardiography Analysis for Enhanced Cardiovascular Assessment of Right Ventricular Failure in Pulmonary Hypertension.International journal of general medicine · 2026Article
- Impaired renal blood perfusion is closely related to right heart volume overload in congestive heart failure.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025Article
- Prognostic value of right ventricular-pulmonary arterial coupling in adults with repaired coarctation of aorta.International journal of cardiology. Congenital heart disease · 2025Article
- Comparison of the prognostic value of right atrial echocardiographic parameters in pulmonary arterial hypertension.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2025Article
- Article
- Impaired right atrial function preceding right ventricular systolic dysfunction: clinical utility and long-term prognostic value in pulmonary hypertension.Insights into imaging · 2025Article
- Comparison of right atrial volume measurements using single-plane area-length and stack-of-short-axis methods: A 3.0 T cardiac magnetic resonance study.BMC medical imaging · 2025Article
- Left atrial stiffness index predicts atrial fibrillation risk in heart failure with preserved ejection fraction: a nomogram model.American journal of translational research · 2025Article
- Pathophysiology of the right ventricle and its pulmonary vascular interaction.The European respiratory journal · 2024Review
- Hemodynamic markers independent of pulmonary capillary wedge pressure can discriminate between pre and postcapillary exercise-induced pulmonary hypertension.Pulmonary circulation · 2024Article
- Plasma Proteomics Identifies B2M as a Regulator of Pulmonary Hypertension in Heart Failure With Preserved Ejection Fraction.Arteriosclerosis, thrombosis, and vascular biology · 2024Article
- Poor cardiac output reserve in pulmonary arterial hypertension is associated with right ventricular stiffness and impaired interventricular dependence.The European respiratory journal · 2024Article
- Clinical-imaging-pathological correlation in pulmonary hypertension associated with left heart disease.European respiratory review : an official journal of the European Respiratory Society · 2024Article
- Non-Interferon-Dependent Role of STING Signaling in Pulmonary Hypertension.Arteriosclerosis, thrombosis, and vascular biology · 2024Article
- Differences in Mechanical, Electrical and Calcium Transient Performance of the Isolated Right Atrial and Ventricular Myocardium of Guinea Pigs at Different Preloads (Lengths).International journal of molecular sciences · 2023Article
- Sex-Specific Impairment of Cardiac Functional Reserve in HFpEF: Insights From the HFpEF Stress Trial.JACC. Advances · 2023Article
- Adaptive versus maladaptive right ventricular remodelling.ESC heart failure · 2023Review
Corrections and comments
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Authors and funding
15 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHeart failure with preserved ejection fraction (HFpEF) is a prevalent disorder for which no effective treatment yet exists. Pulmonary hypertension (PH) and right atrial (RA) and ventricular (RV) dysfunction are frequently observed. The question remains whether the PH with the associated RV/RA dysfunction in HFpEF are markers of disease severity.
methodsTo obtain insight in the relative importance of pressure-overload and left-to-right interaction, we compared RA and RV function in 3 groups: 1. HFpEF (n=13); 2. HFpEF-PH (n=33), and; 3. pulmonary arterial hypertension (PAH) matched to pulmonary artery pressures of HFpEF-PH (PH limited to mPAP ≥30 and ≤50 mmHg) (n=47). Patients underwent right heart catheterization and cardiac magnetic resonance imaging.
resultsThe right ventricle in HFpEF-PH was less dilated and hypertrophied than in PAH. In addition, RV ejection fraction was more preserved (HFpEF-PH: 52±11 versus PAH: 36±12%). RV filling patterns differed: vena cava backflow during RA contraction was observed in PAH only. In HFpEF-PH, RA pressure was elevated throughout the cardiac cycle (HFpEF-PH: 10 [8-14] versus PAH: 7 [5-10] mm Hg), while RA volume was smaller, reflecting excessive RA stiffness (HFpEF-PH: 0.14 [0.10-0.17] versus PAH: 0.08 [0.06-0.11] mm Hg/mL). RA stiffness was associated with an increased eccentricity index (HFpEF-PH: 1.3±0.2 versus PAH: 1.2±0.1) and interatrial pressure gradient (9 [5 to 12] versus 2 [-2 to 5] mm Hg).
conclusionsRV/RA function was less compromised in HFpEF-PH than in PAH, despite similar pressure-overload. Increased RA pressure and stiffness in HFpEF-PH were explained by left atrial/RA-interaction. Therefore, our results indicate that increased RA pressure is not a sign of overt RV failure but rather a reflection of HFpEF-severity.
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