{"id":"c090be50de3d","type":"article","url":"https://hartvaat.nl/2026/05/05/verminderde-rv-vrijewandstrain-voorspelt-mcs-behoefte-bij-cardiogene-shock/","title":"Verminderde RV-vrijewandstrain voorspelt MCS-behoefte bij cardiogene shock","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["cardiogene-shock","rechterventrikelfalen","supraventriculaire-tachycardie","ventrikelfibrilleren"],"journal":"ESC heart failure","doi":"10.1093/eschf/xvag116","source_url":"https://doi.org/10.1093/eschf/xvag116","authors":["Chong Bin Lee","Andreas Merz","Daniel-Armando Morris","Matthias Schneider-Reigbert","Linus Haberbosch","Fabian Spinka","Caroline Büttner","Cheng-Ying Chiu","Ingo Hilgendorf","Robin Kraft","Thomas Schlabs","Athanasios Frydas"],"significance":6,"published":"2026-05-07","source_date":"2026-05-05","image":"","kennis":["https://hartvaat.nl/kennis/diagnostiek/transthoracale-echocardiografie/"],"congress":"","summary_en":"A 92-patient single-centre retrospective study found that severely impaired RV free-wall longitudinal strain (<11%) on early echocardiography predicted need for temporary mechanical circulatory support (OR 10.49) in cardiogenic shock. TAPSE and fractional area change were not predictive. Combining RV FWLS with SOFA score and LVEF achieved 78% accuracy and 95% specificity for MCS escalation. RV strain deserves a role in early risk stratification of cardiogenic shock.","created":"2026-07-03T10:32:52Z","updated":"2026-07-03T13:31:47Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Single-center retrospectief onderzoek bij 92 patiënten met cardiogene shock laat zien dat ernstige verstoring van de rechterventrikel-vrijewand-longitudinale strain (RV FWLS <11%) sterk geassocieerd is met de behoefte aan tijdelijke mechanische circulatie-ondersteuning (OR 10,49). Tricuspidalisringexcursie en fractional area change waren niet voorspellend. Combinatie van RV FWLS met SOFA-score en LVEF gaf 78% accuratesse en 95% specificiteit voor MCS-escalatie. RV-strain verdient een plek in vroege risicostratificatie bij cardiogene shock.","abstract_original":"INTRODUCTION: Early identification of patients with cardiogenic shock (CS) who will require temporary mechanical circulatory support (MCS) remains challenging. Right ventricular (RV) dysfunction is common in CS and affects haemodynamic stability. RV free wall longitudinal strain (RV FWLS) is a sensitive marker of myocardial dysfunction, but its role in predicting MCS escalation in CS remains unclear. METHODS: In this single-centre retrospective study, patients admitted with CS between January 2023 and December 2025 were screened. Inclusion required transthoracic echocardiography within 24 h of CS diagnosis and prior to MCS implantation. RV FWLS was measured using commercially available software. Primary outcome was temporary MCS implantation during hospitalization. Secondary outcomes included in-hospital mortality and intensive care and hospital length of stay. RESULTS: Ninety-two patients were included; 31 (34%) required temporary MCS. Severe RV FWLS impairment (<11%) was strongly associated with temporary MCS use (OR 10.49, 95% CI 3.72-29.59). Tricuspid annular plane systolic excursion and fractional area change were not significantly associated with temporary MCS. Severe RV FWLS was linked to longer intensive care stay (21 vs 8 days, P = .003) and hospital stay (25 vs 14 days, P = .003), but not mortality. RV FWLS demonstrated moderate discrimination (area under the curve, AUC 0.74), improving with left ventricular ejection fraction (LVEF) and Sequential Organ Failure Assessment (SOFA) score (AUC 0.82). A classification and regression tree -derived algorithm using RV FWLS, SOFA score, and LVEF stratified patients into distinct risk groups with 78% overall accuracy and 95% specificity. CONCLUSION: Integration of RV FWLS with clinical parameters may improve early risk stratification in CS."}