Coronary heart failure with preserved ejection fraction (HFpEF) is underdiagnosed in sufferers with extreme secondary tricuspid regurgitation (STR) of undefined etiology (remoted STR), in keeping with a research printed on-line Nov. 6 in JAMA Cardiology.
Jwan A. Naser, M.B.B.S., from the Mayo Clinic in Rochester, Minnesota, and colleagues examined the prevalence of HFpEF and precapillary pulmonary hypertension (PH) in sufferers with extreme remoted STR referred for train proper coronary heart catheterization (RHC) in a cross-sectional research. Fifty-four consecutive sufferers with extreme remoted STR who underwent rest-and-exercise RHC have been included.
The first indication for RHC was analysis of tricuspid regurgitation previous to potential intervention, analysis of PH, and affirmation of HFpEF in 67, 24, and 9% of sufferers, respectively. The researchers recognized HFpEF in 74% of sufferers; in solely 35% of sufferers was HFpEF acknowledged previous to RHC. Precapillary PH was recognized in 10 of the 14 remaining sufferers with out HFpEF (71%). Twenty-four sufferers (60%) who have been subsequently recognized with HFpEF didn’t have guideline-defined diastolic dysfunction. Sturdy discrimination for HFpEF was seen for left atrial emptying fraction and pressure (space below the receiver working attribute curve, 0.90 and 0.91, respectively).
“HFpEF remains underdiagnosed,” the authors write. “Patients with severe STR in the absence of another apparent etiology should be evaluated for HFpEF and precapillary PH.”
Extra info:
Jwan A. Naser et al, Prevalence of HFpEF in Remoted Extreme Secondary Tricuspid Regurgitation, JAMA Cardiology (2024). DOI: 10.1001/jamacardio.2024.3767
Gregg C. Fonarow et al, Coronary heart Failure With Preserved Ejection Fraction—A Function for Invasive Hemodynamics, JAMA Cardiology (2024). DOI: 10.1001/jamacardio.2024.3764
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Coronary heart failure with preserved ejection fraction underdiagnosed (2024, November 25)
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