Echocardiographic assessment of right ventricular function in routine practice: Which parameters are useful to predict one-year outcome in advanced heart failure patients with dilated cardiomyopathy?

Kawata, Takayuki; Daimon, Masao; Kimura, Kôichi; Nakao, Tomoko; Lee, Seitetsu L.; Hirokawa, Megumi; Kato, Tomoko S.; Watanabe, Masafumi; Yatomi, Yutaka; Komuro, Issei

doi:10.1016/j.jjcc.2017.02.007

Cited by 20 publications

(25 citation statements)

References 31 publications

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“…In line with this observation, the association of FAC with outcome was stronger than that of TAPSE in patients with right ventricular arrhythmogenic cardiomyopathy [28]. Similarly, FAC provided better prognostic information than TAPSE in patients with dilated cardiomyopathy [29]. Although TAPSE was significantly associated with outcome in hypertrophic cardiomyopathy and after myocardial infarction [7,30], its lack of prognostic significance in LVNC may be related to the fact that it represents longitudinal function of the basal RV free wall only and cannot reflect global RV function [31].…”

Section: Discussionsupporting

confidence: 53%

Right ventricle and outcome in left ventricular non-compaction cardiomyopathy

Stämpfli

Donati

Hellermann³

et al. 2020

Journal of Cardiology

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Background: The risk of adverse events in patients with left ventricular non-compaction cardiomyopathy (LVNC) is substantial. Information on prognostic factors, however, is limited. This study was designed to assess the prognostic value of right ventricular (RV) size and function in LVNC patients. Methods: Cox regression analyses were used to determine the association of indexed RV end-diastolic area (RV-EDAI), indexed end-diastolic diameter (RV-EDDI), fractional area change (FAC), and tricuspid annular systolic excursion (TAPSE) with the occurrence of death or heart transplantation (composite endpoint). Results: Out of 127 patients (53.2 AE 17.8 years; 61% males, median follow-up time was 7.7 years), 17 patients reached the endpoint. In a univariate analysis, RV-EDAI was the strongest predictor of outcome ) per cm 2 /m 2 ; p < 0.0001]. FAC was predictive as well [HR 1.44 (1.16-1.83) per 5% decrease; p = 0.0009], while TAPSE was not (p=ns). RV-EDAI remained an independent predictor in a bivariable analysis with indexed left ventricular ED volume ) per cm 2 /m 2 ; p = 0.0002], while analysis of FAC and left ventricular ejection fraction demonstrated that FAC was not independent [HR 1.20 (0.98-1.52); per 5% decrease; p = 0.0721]. RV-EDAI 11.5 cm 2 /m 2 was the best cut-off value for separating patients in terms of outcome. Patients with RV-EDAI >11.5 cm 2 /m 2 had a survival rate of 18.5% over 12 years as compared to 93.8% in patients with RV-EDAI <11.5 cm 2 /m 2 (p < 0.0001). Conclusion: Increased end-diastolic RV size and decreased systolic RV function are predictors of adverse outcome in patients with LVNC. Patients with RV-EDAI >11.5 cm 2 /m 2 exhibit a significantly lower survival than those <11.5 cm 2 /m 2 .

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Section: Discussionsupporting

confidence: 53%

Right ventricle and outcome in left ventricular non-compaction cardiomyopathy

Stämpfli

Donati

Hellermann³

et al. 2020

Journal of Cardiology

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“…The results of this retrospective study indicate that right heart hemodynamics and function are of major importance to assess the prognosis of patients with chronic HF with reduced to mid-range Original Article found to be related to the outcome of elderly patients with chronic systolic HF, but little is known regarding the prognostic role of combination of pulmonary hypertension and RV dysfunction [20].…”

Section: Discussionmentioning

confidence: 99%

Echocardiography of right ventricular-arterial coupling predicts survival of elderly patients with heart failure and reduced to mid-range ejection fraction

Rosa

D’Agostino

Giovinazzo

et al. 2020

Monaldi Arch Chest Dis

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Echocardiography of right ventricular (RV)-arterial coupling obtained by the estimation of the ratio of the longitudinal annular systolic excursion of the tricuspid annular plane and pulmonary artery systolic pressure (TAPSE/PASP) has been found to be a remarkable prognostic indicator in patients with HF. Our aim was to evaluate the impact of TAPSE, PASP and their ratio in the prognostic stratification of outpatients with HF aged ≥70 years and reduced to mid-range ejection fraction (EF). A complete echocardiographic examination was performed in 400 outpatients with chronic HF and left ventricular (LV) EF ≤50% who averaged 77 years in age. During a median follow-up period of 25 months (interquartile range: 8-46), there were 135 cardiovascular deaths. Two different Cox regression models were evaluated, one including TAPSE and PASP, separately, and the other with TAPSE/PASP. In the first model, LV end-systolic volume index, age, no angiotensin converting enzyme (ACE) inhibitor use, TAPSE, PASP and gender were found to be independently associated with the outcome after adjustment for demographics, clinical, biochemical, echocardiographic data. In the second model, TAPSE/PASP resulted the most important independent predictor of outcome (hazard ratio [HR]:0.07, p<0.0001) followed by LV end-systolic volume index, no ACE inhibitor use, age and gender. The use of the variable TASPE/PASP improved the predictive value of the new multivariable model (area under the curve [AUC] of 0.74 vs AUC of 0.71; p<0.05). TASPE/PASP improved the net reclassification (NRI = 14.7%; p<0.01) and the integrated discrimination (IDI = 0.04; p<0.01). In conclusion, the study findings showed that assessment of RV-arterial coupling by TAPSE/PASP was of major importance to assess the prognosis of patients with chronic HF and LV EF ≤50% aged ≥70 years.

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“…The RV systolic function, however, can be evaluated using other parameters: tricuspid S wave velocity using Tissue Doppler Imaging, the RV fractional area change (RV FAC), the RV myocardial performance index, or the TEI index, which is a measurement of both systolic and diastolic RV function [ 12 ]. Kawata et al, for example, found that RV FAC may provide better prognostic information than TAPSE or the S wave in advanced heart failure patients with dilated cardiomyopathy [ 16 ]. In our study, RV FAC and S wave were significantly lower in CRT patients who developed adverse cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy

Deaconu

Scărlătescu

Petre

et al. 2021

JCM

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Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulmonary arterial systolic pressure (PASP) has prognostic significance in patients undergoing cardiac resynchronization therapy (CRT). Methods: Patients undergoing CRT were prospectively included. The primary endpoint was adverse cardiovascular events (death and HF-related hospitalizations). RV global longitudinal strain (RVGLS) and RV free wall strain (RVfwS) were measured by speckle tracking and indexed to echocardiographic estimated PASP. Results: A total of 54 patients (64.0 ± 13.8 years; 58% male) were included. After 33 ± 12.9 months, the primary endpoint occurred in 18 patients. Baseline RVGLS/PASP and RVfwS/PASP showed good discriminative ability for response to CRT (AUC = 0.88, 95% CI (0.74–1) and AUC = 0.87, 95% CI (0.77–1)). RVGLS/PASP and RVfwS/PASP were significantly associated with high risk of events at univariate analysis (HR 0.039, 95% CI (0.001–0.8) p < 0.05, respectively HR = 0.049, 95% CI (0.0033–0.72), p < 0.05). Upon multivariate Cox regression analysis, RVGLS/PASP and RVfwS/PASP remained associated with high risk of events (HR 0.018, 95% CI (0.0005–0.64), p = 0.02 and HR 0.015, 95% CI (0.0004–0.524), p = 0.01) after correction for gender, etiology, QRS duration and morphology. Conclusions: Indexing RV longitudinal strain (global and free wall) by PASP provides a parameter, which independently identifies patients with high risk of cardiovascular events and predicts non-response to CRT.

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Echocardiographic assessment of right ventricular function in routine practice: Which parameters are useful to predict one-year outcome in advanced heart failure patients with dilated cardiomyopathy?

Abstract: FAC may provide better prognostic information than TAPSE or S' in advanced heart failure patients with DCM.

Cited by 20 publications

References 31 publications

Right ventricle and outcome in left ventricular non-compaction cardiomyopathy

Right ventricle and outcome in left ventricular non-compaction cardiomyopathy

Echocardiography of right ventricular-arterial coupling predicts survival of elderly patients with heart failure and reduced to mid-range ejection fraction

Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy

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