Abstract 13413: Clinical Outcomes of Right Ventricular Systolic Dysfunction in Patients With Heart Failure With Preserved Ejection Fraction: A Systematic Review and Meta-Analysis

Abstract

Background: Right ventricular systolic dysfunction (RVSD) is a known predictor of survival in patients with heart failure with reduced ejection fraction. However, the association between RVSD and heart failure with preserved ejection fraction (HFpEF) remains unclear. Objectives: We, therefore, conducted a systematic review and meta-analysis to assess the association between RVSD and HFpEF. Method: Two investigators independently searched the databases of MEDLINE and EMBASE from inception to April 28, 2022 to identify the study that reported outcomes of interest in HFpEF with or without RVSD. Primary outcome was a composite outcome of death and heart failure rehospitalization. Secondary outcome was all-cause mortality. RVSD was defined as right ventricular ejection fraction < 50% by echocardiography or cardiovascular magnetic resonance. Data from each study were combined using the random-effects model to calculate pooled hazard ratio (HR) and 95% confidence interval (CI). Results: Five observational studies involving 1,181 patients with HFpEF from December 2014 to May 2021 were included in our meta-analysis. The presence of RV systolic dysfunction in HFpEF patients was associated with a significantly higher risk of composite outcome of death and heart failure rehospitalization (HR 3.29; 95% CI 1.92-5.65; I2 = 52%) and all-cause mortality (HR 1.72; 95% CI 1.16-2.53; I2 = 68%) compared to those without RV systolic dysfunction. Conclusions: Our meta-analysis demonstrates that HFpEF patients with RVSD is associated with a worse outcome compared to those without RVSD.