Right Ventricular Function Score by Echocardiography for Predicting Outcomes After Heart Transplantation
Background The impaired right ventricular (RV) function may occur after heart transplantation (HT). This study aimed to develop a straightforward RV function score (RVFS) using echocardiography to predict adverse clinical events in a large cohort of subjects after HT. Methods A total of 357 consecut...
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Wiley
2025-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.040245 |
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| author | Wei Sun Yuji Xie Ye Zhu Yun Yang Xin Zhang Nianguo Dong Guohua Wang Yuman Li Jing Wang Qing Lv Mingxing Xie Li Zhang |
| author_facet | Wei Sun Yuji Xie Ye Zhu Yun Yang Xin Zhang Nianguo Dong Guohua Wang Yuman Li Jing Wang Qing Lv Mingxing Xie Li Zhang |
| author_sort | Wei Sun |
| collection | DOAJ |
| description | Background The impaired right ventricular (RV) function may occur after heart transplantation (HT). This study aimed to develop a straightforward RV function score (RVFS) using echocardiography to predict adverse clinical events in a large cohort of subjects after HT. Methods A total of 357 consecutive patients post HT who underwent echocardiography at our single institution were retrospectively included. RV systolic function was evaluated by echocardiography. A multivariate Cox regression analysis was performed to identify the independent predictors of RV function for adverse clinical events. Results During a median follow‐up of 39 months from the date of the echocardiography, a composite of adverse events that included death and major adverse cardiac events occurred in 51 patients. The multivariate Cox analysis revealed that RV fractional area change, tricuspid annular plane systolic excursion, and RV free wall longitudinal strain were independent predictors of outcomes after HT. The RVFS was constructed based on these 3 parameters, assigning a value of 1 when a predictor was below its cutoff value from receiver operating characteristic curves and 0 when above. The RVFS outperformed separate RV function parameters in predicting outcomes (area under the curves: 0.84 versus 0.64–0.78, P<0.05). Moreover, incorporating the RVFS into the base clinical model significantly improved the C‐statistic of the prediction model (C‐statistic from 0.70 to 0.83, P<0.001). Conclusions The RVFS, a readily obtainable echo score that combines multiple RV function parameters, exhibits incremental value and significant potential as a robust predictor for adverse outcomes in clinically stable patients after HT. |
| format | Article |
| id | doaj-art-95ab92022cde4041bfedc76bcfe0426e |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-95ab92022cde4041bfedc76bcfe0426e2025-08-20T03:59:22ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-08-01141510.1161/JAHA.124.040245Right Ventricular Function Score by Echocardiography for Predicting Outcomes After Heart TransplantationWei Sun0Yuji Xie1Ye Zhu2Yun Yang3Xin Zhang4Nianguo Dong5Guohua Wang6Yuman Li7Jing Wang8Qing Lv9Mingxing Xie10Li Zhang11Department of Ultrasound Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Ultrasound Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Ultrasound Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Ultrasound Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Ultrasound Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Cardiovascular Surgery Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Cardiovascular Surgery Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Ultrasound Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Ultrasound Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Ultrasound Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Ultrasound Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaDepartment of Ultrasound Medicine Union Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan ChinaBackground The impaired right ventricular (RV) function may occur after heart transplantation (HT). This study aimed to develop a straightforward RV function score (RVFS) using echocardiography to predict adverse clinical events in a large cohort of subjects after HT. Methods A total of 357 consecutive patients post HT who underwent echocardiography at our single institution were retrospectively included. RV systolic function was evaluated by echocardiography. A multivariate Cox regression analysis was performed to identify the independent predictors of RV function for adverse clinical events. Results During a median follow‐up of 39 months from the date of the echocardiography, a composite of adverse events that included death and major adverse cardiac events occurred in 51 patients. The multivariate Cox analysis revealed that RV fractional area change, tricuspid annular plane systolic excursion, and RV free wall longitudinal strain were independent predictors of outcomes after HT. The RVFS was constructed based on these 3 parameters, assigning a value of 1 when a predictor was below its cutoff value from receiver operating characteristic curves and 0 when above. The RVFS outperformed separate RV function parameters in predicting outcomes (area under the curves: 0.84 versus 0.64–0.78, P<0.05). Moreover, incorporating the RVFS into the base clinical model significantly improved the C‐statistic of the prediction model (C‐statistic from 0.70 to 0.83, P<0.001). Conclusions The RVFS, a readily obtainable echo score that combines multiple RV function parameters, exhibits incremental value and significant potential as a robust predictor for adverse outcomes in clinically stable patients after HT.https://www.ahajournals.org/doi/10.1161/JAHA.124.040245echocardiographyheart transplantationprognosisright ventricular function score |
| spellingShingle | Wei Sun Yuji Xie Ye Zhu Yun Yang Xin Zhang Nianguo Dong Guohua Wang Yuman Li Jing Wang Qing Lv Mingxing Xie Li Zhang Right Ventricular Function Score by Echocardiography for Predicting Outcomes After Heart Transplantation Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease echocardiography heart transplantation prognosis right ventricular function score |
| title | Right Ventricular Function Score by Echocardiography for Predicting Outcomes After Heart Transplantation |
| title_full | Right Ventricular Function Score by Echocardiography for Predicting Outcomes After Heart Transplantation |
| title_fullStr | Right Ventricular Function Score by Echocardiography for Predicting Outcomes After Heart Transplantation |
| title_full_unstemmed | Right Ventricular Function Score by Echocardiography for Predicting Outcomes After Heart Transplantation |
| title_short | Right Ventricular Function Score by Echocardiography for Predicting Outcomes After Heart Transplantation |
| title_sort | right ventricular function score by echocardiography for predicting outcomes after heart transplantation |
| topic | echocardiography heart transplantation prognosis right ventricular function score |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.040245 |
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