Heart failure is one of the leading causes of hospital admissions among older adults. It does not always mean that the heart has stopped working.
Instead, it means the heart cannot pump blood around the body as well as it should.
One common form is called heart failure with preserved ejection fraction, or HFpEF. In this condition, the heart still pumps out a normal percentage of blood with each beat, but the heart muscle becomes stiff and cannot relax properly.
This makes it harder for the heart to fill with blood, leading to tiredness, shortness of breath, swelling in the legs, and difficulty exercising. HFpEF has become increasingly common as populations age, yet it remains difficult to diagnose and treat.
Most research on HFpEF has focused on the left side of the heart because it pumps oxygen-rich blood to the rest of the body. However, scientists are learning that the right side of the heart is also very important.
The right ventricle pumps blood to the lungs, where it picks up oxygen. If this chamber becomes weak, known as right ventricular dysfunction (RVD), patients may become much sicker and have a poorer outlook.
A new study from Xiamen Humanity Hospital in China has shown that RVD is far more common in people with HFpEF than many doctors may expect. The findings were published on June 10 in BMC Cardiovascular Disorders.
The research team, led by Xin Du, reviewed the medical records of 163 patients diagnosed with HFpEF between January 2022 and January 2024. Each patient underwent detailed ultrasound scans of the heart, known as echocardiography. The researchers also measured a blood marker called NT-proBNP, which rises when the heart is under stress.
The results showed that 41.7% of the patients already had right ventricular dysfunction. Patients with RVD also had much higher NT-proBNP levels, suggesting their hearts were under greater strain.
The scientists found that several ultrasound measurements worked together to identify patients with RVD. These included measurements of right ventricular movement, pressure in the lung arteries, the size of the left atrium, and how well the heart muscle relaxed. Among all individual measurements, right ventricular free wall strain performed the best.
When the researchers combined six heart ultrasound measurements with NT-proBNP, the test became extremely accurate at identifying patients with RVD. This suggests that doctors may be able to detect problems much earlier by using several measurements together instead of relying on only one test.
Early detection matters because treatment is usually more successful before heart damage becomes severe. Identifying patients with hidden right-sided heart weakness may allow doctors to monitor them more closely, adjust medications, recommend lifestyle changes, and reduce the chance of future complications.
The study also reminds us that HFpEF is a complex disease involving both sides of the heart. Looking beyond the left ventricle could help doctors better understand why some patients worsen more quickly than others.
The findings should still be interpreted carefully. This was a retrospective study from a single hospital involving only 163 patients. It cannot prove that these heart measurements improve survival or prevent hospital admissions.
Larger studies from multiple countries will be needed before this testing approach becomes routine. Even so, the very strong performance of the combined model suggests that this approach deserves further investigation and could become an important tool for personalizing care for people with HFpEF.
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Source: Xiamen Humanity Hospital.
