Bendopnea Predicts Right Ventricular Energy Failure in Patients with Pulmonary Hypertension

OBJECTIVE
The development of right ventricular failure has a significant adverse prognostic impact on the course of pulmonary hypertension (PH). RV energy failure (RVEF) has been shown to double the mortality of PH even after correction for many established risk predictors. We hypothesize that bendopnea may indicate RVEF in patients with PH.


METHODS
We prospectively enrolled patients with PH, who were admitted to our PH outpatient clinic between January 2021 and June 2021. Bendopnea was assessed by asking patients to bend forward and report any shortness of breath within 30 seconds. Routine physical examination, laboratory tests, echocardiography and right heart catheterization parameters were collected.


RESULTS
A total of 167 patients were enrolled into the study. Bendopnea and RVEF was present in 79 (47.3%) and 43 (25.7%) patients, respectively. Bendopnea accurately predicted the presence of RVEF (area under curve, 0.667; 95% confidence interval, 0.574 to 0.760; P<0.001) and had a significantly superior diagnostic power compared with many other symptoms and signs.


CONCLUSION
Our study shows that bendopnea predicts RVEF in patients with PH and can be added to our physical examination armamentarium as an easy, rapid, and noninvasive prognostic tool.