Prognostic Significance of Right Ventricular Dimension on Acute Decompensation in Chronic Left-Sided Heart Failure

Abstract

SummaryRight ventricular (RV) dysfunction has been discussed in relation to an adverse outcome in heart failure (HF). The aim of this study was to analyze the relationship between RV function with HF exacerbation and its subsequent longterm outcome in patients with chronic left-sided HF.We studied 122 consecutive patients who were admitted for dyspnea due to exacerbated left-sided HF with a left ventricular (LV) ejection fraction of less than 40%. Conventional echocardiography was performed in the study subjects on admission and at discharge. Cox proportional hazards analysis revealed that RV end-diastolic dimension (RVDd) (hazard ratio 1.131, P = 0.005, 95% confidence interval 1.039-1.231) and the serum level of creatinine on admission were independent predictors of subsequent cardiac-related death, but RVDd at discharge and other LV parameters were not. Thus, patients were divided into tertiles on the basis of RVDd on admission: < 32 mm (n = 37), 32-40 mm (n = 43), and ≧ 40 mm (n = 42). According to the increase in the RVDd category, the cardiac-related death-free rate significantly decreased. Among the 3 groups, the pulse pressure and serum total bilirubin levels that demonstrated low cardiac output syndrome (LOS) parameters had significant differences.RVDd on admission could be measured noninvasively and easily to predict a worse long-term prognosis of chronic left-sided HF on admission, and showed correlations with LOS parameters. (Int Heart J 2011; 52: 119-126)

Impact of preinterventional tricuspid regurgitation on outcome of MitraClip therapy in patients with severely reduced ejection fraction

“…A reported echocardiographic study emphasised that moderate-to-severe TR can increase the mortality rate regardless of pulmonary hypertension or low ejection fraction 15. According to the literature, dilation of the right ventricle correlates with poor prognosis in patients with severe LV dysfunction 16. In our two groups, none of the echocardiographic variables assessed were significantly different except for TR severity (table 2).…”

“…15 According to the literature, dilation of the right ventricle correlates with poor prognosis in patients with severe LV dysfunction. 16 In our two groups, none of the echocardiographic variables assessed were significantly different except for TR severity (table 2). Although there is no information about TV annulus diameter, we considered that these two groups might be different in terms of the preoperative TV annulus diameter influencing the FTR severity.…”

Implication of right ventricular dysfunction on long-term outcome in patients with ischemic cardiomyopathy undergoing coronary artery bypass grafting with or without surgical ventricular reconstruction

“…RV dysfunction may reflect primary left ventricular, left atrial, or mitral valve pathology (16,17) mediated through direct RV compression and the mechanism of RV/LV interdependence or through increased pulmonary pressures and RV after load due to LV dysfunction (18,19). Alternatively, both ventricles might be affected by the same underlying pathological process (CAD) (20).…”

Normal Echocardiographic Measurements in a Korean Population Study: Part I. Cardiac Chamber and Great Artery Evaluation

“… 1) Recently, there were improvements in echocardiographic techniques including higher resolution with harmonic imaging and better information about cardiac structure, function, and prognostic values became available. 2) 3) Current echocardiographic guidelines recommend that physicians measure and provide detailed information on both right- and left-sided cardiac chambers when evaluating patients. 4) 5) Although there are reports on normal echocardiographic data, reference values for cardiac structure and function may be influenced by physical characteristics of the target population.…”