The prognostic value of right ventricular longitudinal strain and 3D ejection fraction in patients with dilated cardiomyopathy.
Dilated cardiomyopathy
Right ventricular ejection fraction
Right ventricular strain
Journal
The international journal of cardiovascular imaging
ISSN: 1875-8312
Titre abrégé: Int J Cardiovasc Imaging
Pays: United States
ID NLM: 100969716
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
received:
28
04
2021
accepted:
18
06
2021
pubmed:
25
6
2021
medline:
3
11
2021
entrez:
24
6
2021
Statut:
ppublish
Résumé
Several studies showed that right ventricular (RV) dysfunction is a powerful predictor in heart failure (HF). Advanced echocardiographic techniques such as speckle-tracking imaging and three-dimensional (3D) echocardiography proved to be accurate tools for RV assessment, but their clinical significance remains to be clarified. The aim of this study was to evaluate the role of two-dimensional (2D) RV strain and 3D ejection fraction (RVEF) in predicting adverse outcome in patients with non-ischemic dilated cardiomyopathy (DCM). We prospectively screened 81 patients with DCM and sinus rhythm, 50 of whom were enrolled and underwent comprehensive echocardiography, including RV strain and 3D RV volumetric assessment. Patients were followed for a composite endpoint of cardiac death, nonfatal cardiac arrest and acute worsening of HF requiring hospitalization. After a median follow-up of 16 months, 29 patients reached the primary endpoint. Patients with events had more impaired RV global longitudinal strain (- 10.5 ± 4.5% vs. - 14.3 ± 5.2%, p = 0.009), RV free wall longitudinal strain (- 12.9 ± 8.7% vs. - 17.5 ± 7.1%, p = 0.046) and 3D RVEF (38 ± 8% vs. 47 ± 9%, p = 0.001). By Cox proportional hazards multivariable analysis, RV global longitudinal strain and RVEF were independent predictors of outcome after adjustment for age and NYHA class. RVEF remained the only independent predictor of events after further correction for echocardiographic risk factors. By receiver-operating characteristic analysis, the optimal RVEF cut-off value for event prediction was 43.4% (area under the curve = 0.768, p = 0.001). Subjects with RVEF > 43.4% showed more favourable outcome compared to those with RVEF < 43.4% (log-rank test, p < 0.001). In conclusion, 3D RVEF is an independent predictor of major adverse cardiovascular events in patients with DCM.
Identifiants
pubmed: 34165699
doi: 10.1007/s10554-021-02322-z
pii: 10.1007/s10554-021-02322-z
pmc: PMC8223765
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3233-3244Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Nature B.V.
Références
Echocardiography. 2018 Jan;35(1):47-55
pubmed: 29106754
J Hypertens. 2018 Mar;36(3):690-700
pubmed: 29035940
J Am Coll Cardiol. 2003 Aug 20;42(4):736-42
pubmed: 12932612
Circ Cardiovasc Imaging. 2017 Feb;10(2):
pubmed: 28174197
Circ Cardiovasc Imaging. 2016 Feb;9(2):e003866
pubmed: 26860970
Am J Cardiol. 2020 Nov 1;134:116-122
pubmed: 32891401
Eur J Heart Fail. 2016 Aug;18(8):891-975
pubmed: 27207191
Eur Heart J Cardiovasc Imaging. 2018 Jun 1;19(6):591-600
pubmed: 29596561
Echo Res Pract. 2020 Feb 27;7(1):G19-G41
pubmed: 32105053
Eur Heart J Cardiovasc Imaging. 2016 Nov;17(11):1279-1289
pubmed: 26647080
Int J Cardiol. 2012 Feb 23;155(1):120-5
pubmed: 21664707
J Am Soc Echocardiogr. 2019 Nov;32(11):1407-1415.e3
pubmed: 31400846
Eur Heart J Cardiovasc Imaging. 2019 Sep 1;20(9):1043-1050
pubmed: 30796431
J Am Coll Cardiol. 2010 Jun 8;55(23):2614-62
pubmed: 20513610
ESC Heart Fail. 2021 Apr;8(2):1388-1397
pubmed: 33599109
Int J Cardiol. 2014 Dec 15;177(2):429-35
pubmed: 25304065
J Am Coll Cardiol. 2014 Jul 8;64(1):41-51
pubmed: 24998127
Heart Fail Rev. 2019 Jul;24(4):511-520
pubmed: 30852772
Eur J Heart Fail. 2017 Jul;19(7):873-879
pubmed: 27860029
Eur J Heart Fail. 2020 Dec;22(12):2225-2227
pubmed: 33125819
J Cardiovasc Ultrasound. 2014 Sep;22(3):113-20
pubmed: 25309687
Cardiovasc Ultrasound. 2013 Jun 03;11:19
pubmed: 23731725
Circ Cardiovasc Imaging. 2018 Jan;11(1):e006894
pubmed: 29321212
J Am Soc Echocardiogr. 2014 Jul;27(7):726-32
pubmed: 24679740
Eur Heart J Cardiovasc Imaging. 2015 Mar;16(3):233-70
pubmed: 25712077
Circulation. 2013 Oct 8;128(15):1623-33
pubmed: 23965488
J Am Soc Echocardiogr. 2010 Feb;23(2):116-26
pubmed: 20152692
JACC Cardiovasc Imaging. 2019 Dec;12(12):2373-2385
pubmed: 30772232
J Am Soc Echocardiogr. 2010 Jul;23(7):685-713; quiz 786-8
pubmed: 20620859
Cardiol J. 2017;24(5):563-572
pubmed: 28497844
Circ Cardiovasc Imaging. 2013 Sep;6(5):711-21
pubmed: 23811750
Curr Cardiol Rev. 2017;13(2):118-129
pubmed: 27799029
JACC Cardiovasc Imaging. 2017 Oct;10(10 Pt B):1289-1290
pubmed: 29025580
J Thorac Cardiovasc Surg. 2014 Dec;148(6):3166-71.e1-4
pubmed: 24973008
J Am Soc Echocardiogr. 2019 Jan;32(1):1-64
pubmed: 30282592
Echocardiography. 2016 Jul;33(7):992-1000
pubmed: 26864642
Eur Heart J. 2016 Jun 14;37(23):1850-8
pubmed: 26792875