Evidence map›Paper›PMID 42860037›Full record

ArticleCirculation2026

Prominent V Waves Augment Right Ventricular Afterload Independent of the Lung Vessels in Heart Failure: Implications for Clinical Assessment of Pulmonary Vascular Disease.

Thanat Chaikijurajai, Yogesh N V Reddy, Tomonari Harada, Jwan A Naser, Sho Kazui, Naoyuki Akashi, Takahiro Okuno, Fahime Ghanbari, Barry A Borlaug

Abstract read
In one paragraph

Article in Circulation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Thanat ChaikijurajaiDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.ORCID 0000-0003-0651-0434
Yogesh N V ReddyDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.ORCID 0000-0001-5322-0902
Tomonari HaradaDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
Jwan A NaserDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.ORCID 0000-0002-6210-7669
Sho KazuiDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.ORCID 0009-0001-8646-4361
Naoyuki AkashiDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.ORCID 0000-0002-8603-2630
Takahiro OkunoDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.ORCID 0009-0007-1871-8634
Fahime GhanbariDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
Barry A BorlaugDepartment of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.ORCID 0000-0001-9375-0596

Funding

Pulmonary Hypertension in Left Heart DiseaseR01HL162828 · NHLBI · MAYO CLINIC ROCHESTER · PI Barry A. Borlaug, Margaret M Redfield · 2023 to 2026
$3.1M
Using Novel Imaging Biomarkers to Uncover Sex Differences in Heart FailureU54HL179918 · NHLBI · MAYO CLINIC ROCHESTER · PI Barry A. Borlaug, Ryan T. Demmer · 2026 to 2026
$3.0M
HL-Inorganic Nitrite to Enhance Benefits from Exercise Training in Heart Failure with preserved Ejection FractionR01HL128526 · NHLBI · MAYO CLINIC ROCHESTER · PI BORLAUG, BARRY A. · 2016 to 2019
$2.4M
Mayo Clinic HeartShare Clinical CenterU01HL160226 · NHLBI · MAYO CLINIC ROCHESTER · PI Barry A. Borlaug, Margaret M Redfield · 2021 to 2026
$1.8M
NHLBI NIH HHS R01 HL128526NHLBI NIH HHS R01 HL162828NHLBI NIH HHS U01 HL160226NHLBI NIH HHS U54 HL179918
6 · The paper itself

Abstract

backgroundLeft atrial (LA) stiffening augments the LA V wave, pressurizing the pulmonary artery (PA) out of proportion to left ventricular end-diastolic pressure. We characterized the pathophysiologic, diagnostic, and clinical implications of LA stiffening, as defined by prominent V waves, in heart failure with preserved ejection fraction.

methodsIn this retrospective cohort study, patients with heart failure with preserved ejection fraction and less than moderate mitral regurgitation at rest underwent invasive hemodynamic exercise testing. Patients with heightened operant LA stiffening were defined by the PA wedge pressure (PAWP) V wave exceeding mean PAWP by ≥10 mm Hg. A previously used formula for V wave-corrected PAWP was validated against the PAWP waveform pressure-time-area to explore impact of the V wave on transpulmonary pressure gradients. Clinical, echocardiographic, hemodynamic, and outcome data were compared for patients with and without prominent V waves.

resultsCompared with patients without prominent V waves (n=844, 79%), those with prominent V waves (n=225, 21%) were older and more likely to be women, with more severe LA myopathy, evidenced by greater LA volume index (42.2±15.0 versus 32.5±13.0 mL/m

conclusionsMore than 1 in 5 patients with heart failure with preserved ejection fraction display prominent V waves in excess of end-diastolic PAWP. This augments right ventricular afterload due to backward transmission of the V wave, contributing to right heart failure that is independent of the pulmonary vasculature. Failure to account for the V wave during hemodynamic assessment overestimates the severity of pulmonary vascular disease present.

Indexed as

atrial fibrillationheart failureHFpEFphenotypeprognosisstiff left atrium

Identifiers

PMID42860037
PMCPMC13660403

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.