Right Ventricular Global Longitudinal Strain Provides Prognostic Value Incremental to Left Ventricular Ejection Fraction in Patients with Heart Failure - 19/06/14
Abstract |
Background |
Right ventricular (RV) global longitudinal strain (RV strain) is a sensitive measure of RV mechanics. Its relationship with standard clinical markers and long-term events in chronic systolic heart failure is not well established. The aim of this study was to examine the ability of RV strain to provide incremental prognostic value to left ventricular (LV) ejection fraction (LVEF) in patients with chronic systolic heart failure.
Methods |
In 171 patients with chronic systolic heart failure (LVEF ≤ 35%), a retrospective substudy of RV strain was performed using Velocity Vector Imaging to analyze previously recorded, comprehensive echocardiographic images. Death, cardiac transplantation, and heart failure hospitalization were tracked for 5 years.
Results |
In this study cohort (mean age, 57 ± 14 years; mean LVEF, 25 ± 6%), mean RV strain was −11.6 ± 5.4%. More impaired RV strain was associated with increasing New York Heart Association class (rank-sums P < .0001) and greater LV volume (LV end-systolic volume index: r = 0.35, P < .0001). Worse RV strain was associated with reduced LVEF (r = −0.45, P < .0001), worse LV diastolic dysfunction (E/e′ septal: r = 0.19, P = .017; left atrial volume index: r = 0.18, P = .031), and standard indices of RV systolic and diastolic dysfunction (RV s′: r = −0.43, P < .0001; RV e′/a′: r = 0.16, P = .0040; right atrial volume index: r = 0.20, P = .015). RV strain predicted long-term adverse events (hazard ratio, 1.30; 95% confidence interval, 1.02–1.70; P = .037). Furthermore, RV strain ≥ −14.8% predicted adverse events after adjustment for age, LVEF, RV s′, E/e′ septal, and right atrial volume index.
Conclusion |
In patients with chronic systolic heart failure, worse RV strain provides prognostic value incremental to LV function.
Le texte complet de cet article est disponible en PDF.Keywords : Right ventricle, Strain, Prognosis, Heart failure
Abbreviations : ADEPT, HF, LV, LVEF, RA, RV, VVI
Plan
| The Assessment of Doppler Echocardiography Prognosis and Therapy study was supported by the American Society of Echocardiography (Morrisville, North Carolina). W.H.W.T is a consultant to and has received grant support from Medtronic, Inc, St Jude Medical, and Abbott Laboratories. All other authors have reported they have no relationships relevant to the contents of this paper to disclose. |
Vol 27 - N° 7
P. 726-732 - juillet 2014 Retour au numéro
Article précédent
- The Ratio of Early Mitral Inflow Velocity to Global Diastolic Strain Rate as a Useful Predictor of Cardiac Outcomes in Patients with Atrial Fibrillation
- Po-Chao Hsu, Wen-Hsien Lee, Chun-Yuan Chu, Chee-Siong Lee, Hsueh-Wei Yen, Ho-Ming Su, Tsung-Hsien Lin, Wen-Chol Voon, Wen-Ter Lai, Sheng-Hsiung Sheu
- Prognostic Value of Echocardiographic Changes in Patients with Pulmonary Arterial Hypertension Receiving Parenteral Prostacyclin Therapy
- Adriano R. Tonelli, Diego Conci, Balaji K. Tamarappoo, Jennie Newman, Raed A. Dweik
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?