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

Prominent V waves in heart failure with preserved ejection fraction are linked to increased right ventricular afterload, independent of pulmonary vasculature, in over 20% of patients.

• Why it matters: Understanding the impact of LA stiffening and V waves is crucial because they can lead to misinterpretation of pulmonary vascular disease severity and influence clinical management of heart failure patients.
• What they did: The study analyzed 1069 patients with heart failure with preserved ejection fraction through invasive hemodynamic exercise testing, comparing those with and without prominent V waves defined by PAWP V wave exceeding mean PAWP by ≥10 mm Hg.
• The result: Patients with prominent V waves exhibited higher pulmonary artery systolic pressure, lower pulmonary compliance, more severe right ventricular dysfunction, and a doubled risk of hospitalization or death, highlighting the importance of accounting for V waves in assessment.