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Prognostic value of right ventricular–pulmonary artery coupling in patients with muscular dystrophies
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  • Published: 12 February 2026

Prognostic value of right ventricular–pulmonary artery coupling in patients with muscular dystrophies

  • Abdallah Fayssoil1,2,3,9,
  • Nicolas Mansencal1,
  • Cendrine Chaffaut4,
  • Karim Wahbi5,
  • Frederic Lofaso6,
  • Helene Prigent6,
  • David Orlikowski7,
  • Bernard Clair7,
  • Pascal Laforet8,
  • Guillaume Bassez3,
  • Anthony Behin3,
  • Bertrand Fontaine3,
  • Henri -Marc Becane3,
  • Denis Duboc5,
  • Olivier Dubourg1,
  • Sylvie Chevret4,
  • Djillali Annane7 &
  • …
  • Tanya Stojkovic3 

Scientific Reports , Article number:  (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Cardiology
  • Neurology

Abstract

Muscular dystrophies can affect the heart and the respiratory system. Right ventricular‒pulmonary artery (RV‒PA) coupling may reflect right ventricular adaptation to respiratory status. Since RV function is very sensitive to afterload, evaluating RV function coupled with pulmonary circulation is more relevant for assessing clinical issues in patients. The aim of this study was to assess the prognostic value of the tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (TAPSE/sPAP), an index of RV–PA coupling, in patients with Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD) and sarcoglycanopathies. The study included retrospectively, from 2015 to 2023, patients with DMD, BMD and sarcoglycanopathies, who were followed in Pitié-Salpêtrière Hospital and Raymond-Poincaré Hospital (France) and who benefited from echocardiography that included a measurement of TAPSE/sPAP. The primary goal was to assess the prognostic value of the TAPSE/sPAP in terms of predicting cardiac events. The study included 113 patients (median age 28 years): DMD (n = 60, 53%), BMD (n = 33, 29%) and sarcoglycanopathies (n = 20, 18%). Home mechanical ventilation was present in 51 patients (46%), and 69% of the patients were wheelchair bound. Left ventricular systolic dysfunction (LVEF < 50%) was present in 37% of the patients. The median sPAP was 22 mmHg [19–27], whereas the median TAPSE was 16 mm [13–18]. Using a Cox model, we found that the TAPSE/sPAP*10 was significantly associated with cardiac events; the higher the TAPSE/sPAP, the better was the outcome (HR 0.33, 95% CI [0.16–0.69], p 0.003). According to the Youden criterion, the cutoff TAPSE/sPAP*10 was 5.3 mm/mmHg. RV–PA coupling, defined by the TAPSE/sPAP, may be a prognostic biomarker in patients with muscular dystrophies.

Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

References

  1. Birnkrant, D. J. et al. Diagnosis and management of Duchenne muscular dystrophy, part 2: respiratory, cardiac, bone health, and orthopaedic management. Lancet Neurol. 17 (4), 347–361 (2018).

    Google Scholar 

  2. Guazzi, M. et al. Tricuspid annular plane systolic excursion and pulmonary arterial systolic pressure relationship in heart failure: an index of right ventricular contractile function and prognosis. Am. J. Physiol. Heart Circ. Physiol. 305 (9), H1373–H1381 (2013).

    Google Scholar 

  3. Ghio, S. et al. All investigators. Different correlates but similar prognostic implications for right ventricular dysfunction in heart failure patients with reduced or preserved ejection fraction. Eur. J. Heart Fail. 19 (7), 873–879 (2017).

    Google Scholar 

  4. Houston, B. A., Brittain, E. L. & Tedford, R. J. Right Ventricular Fail. N Engl. J. Med. ;388(12):1111–1125. (2023).

    Google Scholar 

  5. Kjaergaard, J. et al. Prognostic importance of pulmonary hypertension in patients with heart failure. Am. J. Cardiol. 99 (8), 1146–1150 (2007).

    Google Scholar 

  6. Guazzi, M. et al. RV contractile function and its coupling to pulmonary circulation in heart failure with preserved ejection fraction: stratification of clinical phenotypes and outcomes. JACC Cardiovasc. Imaging. 10 (10 Pt B), 1211–1221 (2017).

    Google Scholar 

  7. Neelakantan, S. et al. Right ventricular stiffening and anisotropy alterations in pulmonary hypertension: mechanisms and relations to right heart failure. J. Am. Heart Assoc. 14 (5), e037126 (2025).

    Google Scholar 

  8. Jentzer, J. C. et al. Right ventricular pulmonary artery coupling and mortality in cardiac intensive care unit patients. J. Am. Heart Assoc. 10 (7), e019015 (2021).

    Google Scholar 

  9. Rudski, L. G. et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American society of echocardiography endorsed by the European association of echocardiography, a registered branch of the European society of Cardiology, and the Canadian society of echocardiography. J. Am. Soc. Echocardiogr. 23 (7), 685–713 (2010).

    Google Scholar 

  10. Currie, P. J. et al. Continuous wave doppler determination of right ventricular pressure: a simultaneous doppler-catheterization study in 127 patients. J. Am. Coll. Cardiol. 6 (4), 750–756 (1985).

    Google Scholar 

  11. Simonds, A. K. Respiratory complications of the muscular dystrophies.Semin respir. Crit. Care Med. 23 (3), 231–238 (2002).

    Google Scholar 

  12. Whittenberger, J. L., Mcgregor, M., Berglunde E., & Borst H. G. Influence of state of inflation of the lung on pulmonary vascular resistance. J. Appl. Physiol. 15, 878–878 (1960).

    Google Scholar 

  13. Van den Berg, P. C., Jansen, J. R. & Pinsky, M. R. Effect of positive pressure on venous return in volume-loaded cardiac surgical patients. J. Appl. Physiol. (1985). 92 (3), 1223–1231 (2002).

    Google Scholar 

  14. Haddad, F., Doyle, R., Murphy, D. J. & Hunt, S. A. Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation; 117(13):1717–1731 (2008).

  15. Yotsukura, M., Miyagawa, M., Tsuya, T., Ishihara, T. & Ishikawa, K. Pulmonary hypertension in progressive muscular dystrophy of the Duchenne type. Jpn Circ. J. 52 (4), 321–326 (1988).

    Google Scholar 

  16. de Groote, P. et al. Right ventricular ejection fraction is an independent predictor of survival in patients with moderate heart failure. J. Am. Coll. Cardiol. 32 (4), 948–954 (1998).

    Google Scholar 

  17. Damy, T. et al. Determinants and prognostic value of pulmonary arterial pressure in patients with chronic heart failure. Eur. Heart J. 31 (18), 2280–2290 (2010).

    Google Scholar 

  18. Vonk Noordegraaf, A., Westerhof, B. E. & Westerhof, N. The relationship between the right ventricle and its load in pulmonary hypertension. J. Am. Coll. Cardiol. 69 (2), 236–243 (2017).

    Google Scholar 

  19. Bosch, L. et al. Right ventricular dysfunction in left-sided heart failure with preserved versus reduced ejection fraction. Eur. J. Heart Fail. 19 (12), 1664–1671 (2017).

    Google Scholar 

  20. Nakagawa, A. et al. Prognostic importance of right Ventricular-Vascular uncoupling in acute decompensated heart failure with preserved ejection fraction. Circ. Cardiovasc. Imaging. 13 (11), e011430 (2020).

    Google Scholar 

  21. Naseem, M., Alkassas, A. & Alaarag, A. Tricuspid annular plane systolic excursion/pulmonary arterial systolic pressure ratio as a predictor of in-hospital mortality for acute heart failure. BMC Cardiovasc. Disord. 22 (1), 414 (2022).

    Google Scholar 

  22. Santas, E. et al. Usefulness of right ventricular to pulmonary circulation coupling as an indicator of risk for recurrent admissions in heart failure with preserved ejection fraction. Am. J. Cardiol. 124 (4), 567–572 (2019).

    Google Scholar 

  23. Nochioka, K. et al. Right ventricular Function, right ventricular-Pulmonary artery Coupling, and heart failure risk in 4 US communities: the atherosclerosis risk in communities (ARIC) Study.JAMA cardiol; 3(10):939–948 (2018).

  24. Gorter, T. M. et al. Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the heart failure association of the European society of cardiology. Eur. J. Heart Fail. 20 (1), 16–37 (2018).

    Google Scholar 

  25. Friedberg, M. K. & Redington, A. N. Right versus left ventricular failure: differences, similarities. Interact. Circulation. 129 (9), 1033–1044 (2014).

    Google Scholar 

  26. Berlin, D. A. & Bakker, J. Underst. Venous return. Intensive Care Med. ;40(10):1564–1566. (2014).

    Google Scholar 

  27. Janda, S., Shahidi, N., Gin, K. & Swiston, J. Diagnostic accuracy of echocardiography for pulmonary hypertension: a systematic review and meta-analysis. Heart 97 (8), 612–622. https://doi.org/10.1136/hrt.2010.212084 (2011).

    Google Scholar 

  28. Currie, P. J. et al. Continuous wave doppler determination of right ventricular pressure: a simultaneous doppler-catheterization study in 127 patients. J. Am. Coll. Cardiol. 6, 750–756 (1985).

    Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Ambroise Paré Hospital, Assistance Publique- Hôpitaux de Paris (AP-HP), Université de Versailles-Saint Quentin (UVSQ), Boulogne-Billancourt, France

    Abdallah Fayssoil, Nicolas Mansencal & Olivier Dubourg

  2. Université Paris-Saclay, UVSQ, END-ICAP, Inserm U 1179, Montigny Le Bretonneux, France

    Abdallah Fayssoil

  3. Myology Institute, Pitié Salpetrière Hospital, Paris, France

    Abdallah Fayssoil, Guillaume Bassez, Anthony Behin, Bertrand Fontaine, Henri -Marc Becane & Tanya Stojkovic

  4. SBIM, Saint Louis Hospital, Paris, France

    Cendrine Chaffaut & Sylvie Chevret

  5. Department of Cardiology, Cochin Hospital, APHP, Paris, France

    Karim Wahbi & Denis Duboc

  6. Department of Physiology, Raymond Poincaré Hospital, APHP, Garches, France

    Frederic Lofaso & Helene Prigent

  7. Intensive Care Unit, Raymond Poincaré Hospital, APHP, Garches, France

    David Orlikowski, Bernard Clair & Djillali Annane

  8. Department of Neurology, Raymond Poincaré Hospital, APHP, Garches, France

    Pascal Laforet

  9. AP-HP, Hôpital Universitaire Ambroise Paré Service de Cardiologie et des Maladies Vasculaires, 9 avenue Charles de Gaulle, Boulogne, 92100, France

    Abdallah Fayssoil

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Contributions

AF designed and wrote the main manuscript and drafted the final version. SC and CC performed the statistical analysis.TS and DA corrected and improved scientifically the manuscript.KW, DD, FL, PL, DO, HP, GB, AB, HMB , BC, BF, OD, NM reviewed, improved substancially and approved the manuscript.

Corresponding author

Correspondence to Abdallah Fayssoil.

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Fayssoil, A., Mansencal, N., Chaffaut, C. et al. Prognostic value of right ventricular–pulmonary artery coupling in patients with muscular dystrophies. Sci Rep (2026). https://doi.org/10.1038/s41598-026-39683-1

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  • Received: 18 April 2025

  • Accepted: 06 February 2026

  • Published: 12 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-39683-1

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Keywords

  • Duchenne muscular dystrophy
  • Becker muscular dystrophy
  • Sarcoglycanopathy
  • Right ventriculopulmonary artery coupling
  • Prognosis
  • Echocardiography
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