Aim: The aim of the present study was to determine the association between the newly proposed echocardiographic LVFP parameter, visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score, and clinical outcomes of HFpEF. Methods: This was a retrospective observational study that assessed the VMT score and clinical outcomes in patients with HFpEF in the Department of Cardiology, IGIMS, PATNA, Bihar, India. 200 patients were included in the study. Results: Out of 200 patients, 36 patients were under VMT0, 130 in VMT1 and 34 in VMT 2 or 3. While LV volume was increased in patients with VMT 2/3, LV wall thickness and EF were similar among the groups, resulting in greater LV mass index and stroke volume in this group. Mitral E wave velocity, E/A, LA volume index, TR pressure gradient, and E/e0 were increased, and the deceleration time of the E wave and LV isovolumic relaxation time were shortened in accordance with the VMT score, resulting in the higher prevalence of elevated LVFP judged by the 2016 ASE/EACVI recommendations in VMT 2/3. There was an increase in the prevalence of significant mitral regurgitation in the higher VMT scores. RV dimensions and RA volume were also increased with the VMT score which could be associated with a higher prevalence of significant TR in VMT 2/3. While RV systolic function was similar between the groups, the VMT 2/3 was characterized by a larger IVC diameter and lower its respiratory change. Conclusion: In patients with HFpEF, the VMT score was independently and incrementally associated with adverse clinical outcomes. Moreover, it could also predict clinical outcomes in HFpEF patients with AF.

Aim: The aim of the present study was to determine the association between the newly proposed echocardiographic LVFP parameter, visually assessed time difference between the mitral valve and tricuspid valve opening (VMT) score, and clinical outcomes of HFpEF. Methods: This was a retrospective observational study that assessed the VMT score and clinical outcomes in patients with HFpEF in the Department of Cardiology, IGIMS, PATNA, Bihar, India. 200 patients were included in the study. Results: Out of 200 patients, 36 patients were under VMT0, 130 in VMT1 and 34 in VMT 2 or 3. While LV volume was increased in patients with VMT 2/3, LV wall thickness and EF were similar among the groups, resulting in greater LV mass index and stroke volume in this group. Mitral E wave velocity, E/A, LA volume index, TR pressure gradient, and E/e0 were increased, and the deceleration time of the E wave and LV isovolumic relaxation time were shortened in accordance with the VMT score, resulting in the higher prevalence of elevated LVFP judged by the 2016 ASE/EACVI recommendations in VMT 2/3. There was an increase in the prevalence of significant mitral regurgitation in the higher VMT scores. RV dimensions and RA volume were also increased with the VMT score which could be associated with a higher prevalence of significant TR in VMT 2/3. While RV systolic function was similar between the groups, the VMT 2/3 was characterized by a larger IVC diameter and lower its respiratory change. Conclusion: In patients with HFpEF, the VMT score was independently and incrementally associated with adverse clinical outcomes. Moreover, it could also predict clinical outcomes in HFpEF patients with AF.