Prognostic value of right ventricular echocardiographic measures in patients with heart failure with reduced ejection fraction.
2DSTE
echocardiography
heart failure
right ventricle
speckle tracking
Journal
Journal of clinical ultrasound : JCU
ISSN: 1097-0096
Titre abrégé: J Clin Ultrasound
Pays: United States
ID NLM: 0401663
Informations de publication
Date de publication:
Nov 2021
Nov 2021
Historique:
revised:
22
06
2021
received:
13
01
2021
accepted:
26
07
2021
pubmed:
3
8
2021
medline:
28
10
2021
entrez:
2
8
2021
Statut:
ppublish
Résumé
Right ventricular (RV) dysfunction is associated with poor outcome in patients with heart failure. In order to better predict mortality in this patient group we wanted to compare the prognostic value of conventional and advanced RV echocardiographic measures. Echocardiographic examinations were retrieved from 701 patients. End point was all-cause mortality and follow-up 100%. RV parameters were measured offline in accordance with current guidelines. Speckle tracking was derived using the algorithm originally designed for the left ventricle. During follow-up (median: 39 months) 118 patients (16.8%) died. RV global longitudinal strain (GLS) and RV free wall strain (FWS) remained associated with mortality after multivariable adjustment independent of Tricuspid annular plane systolic excursion (TAPSE) (RV GLS: HR 1.07, 95%CI 1.02-1.13, p = 0.010, per 1% decrease) (RV FWS: HR 1.05, 95%CI 1.01-1.09, p = 0.010, per 1% decrease). This seemed to be caused by significant associations in men. All RV estimates provided prognostic information incremental to established risk factors and significantly increased C-statistics. RV GLS and FWS were associated with mortality in HFrEF patients after multivariable adjustment independent of TAPSE. TAPSE, however, remained as the strongest prognosticator in women. More research is needed to identify whether speckle tracking could be superior to conventional RV measures in identifying HFrEF patients with poor outcome.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
903-913Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Heidenreich PA, Albert NM, Allen LA, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013;6(3):606-619. https://doi.org/10.1161/HHF.0b013e318291329a
Haddad F, Doyle R, Murphy DJ, Hunt SA. Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation. 2008;117(13):1717-1731. https://doi.org/10.1161/CIRCULATIONAHA.107.653584
Di Salvo TG, Mathier M, Semigran MJ, William Dec FG. Preserved right ventricular ejection fraction predicts exercise capacity and survival in advanced heart failure. J Am Coll Cardiol. 1995;25(5):1143-1153. https://doi.org/10.1016/0735-1097(94)00511-N
De Groote P, Millaire A, Foucher-Hossein C, et al. Right ventricular ejection fraction is an independent predictor of survival in patients with moderate heart failure. J Am Coll Cardiol. 1998;32(4):948-954. https://doi.org/10.1016/S0735-1097(98)00337-4
Juilliere Y, Barbier G, Feldmann L, Grentzinger A, Danchin N, Cherrier F. Additional predictive value of both left and right ventricular ejection fractions on long-term survival in idiopathic dilated cardiomyopathy. Eur Heart J. 1997;18(2):276-280. https://doi.org/10.1093/oxfordjournals.eurheartj.a015231
Ghio S, Guazzi M, Scardovi AB, et al. Different correlates but similar prognostic implications for right ventricular dysfunction in heart failure patients with reduced or preserved ejection fraction. Eur J Heart Fail. 2017;19(7):873-879. https://doi.org/10.1002/ejhf.664
Tadic M, Pieske-Kraigher E, Cuspidi C, et al. Right ventricular strain in heart failure: clinical perspective. Arch Cardiovasc Dis. 2017;110(10):562-571. https://doi.org/10.1016/j.acvd.2017.05.002
Hundley WG, Bluemke DA, Finn JP, et al. ACCF/ACR/AHA/NASCI/SCMR 2010 expert consensus document on cardiovascular magnetic resonance. J Am Coll Cardiol. 2010;55(23):2614-2662. https://doi.org/10.1016/j.jacc.2009.11.011
Lu KJ, Chen JXC, Profitis K, et al. Right ventricular global longitudinal strain is an independent predictor of right ventricular function: a multimodality study of cardiac magnetic resonance imaging, real time three-dimensional echocardiography and speckle tracking echocardiography. Echocardiography. 2015;32(6):966-974. https://doi.org/10.1111/echo.12783
Sengeløv M, Jørgensen PG, Jensen JS, et al. Global longitudinal strain is a superior predictor of all-cause mortality in heart failure with reduced ejection fraction. JACC Cardiovasc Imaging. 2015;8(12):1351-1359. https://doi.org/10.1016/j.jcmg.2015.07.013
Lundorff IJ, Sengeløv M, Jørgensen PG, et al. Echocardiographic predictors of mortality in women with heart failure with reduced ejection fraction. Circ Cardiovasc Imaging. 2018;11(11):e008031.
Ponikowski P, Voors AA, Anker SD, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016;37(27):2129-2200. https://doi.org/10.1093/eurheartj/ehw128
Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging. Eur Heart J Cardiovasc Imaging. 2015;16(3):233-271. https://doi.org/10.1093/ehjci/jev014
Goff DJ, Lloyd-Jones D, Bennett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/ American Heart Association task force on practice guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2935. https://doi.org/10.1161/01.cir.0000437741.48606.98
Molinari N, Durand JF, Sabatier R. Bounded optimal knots for regression splines. Comput Stat Data anal. 2004;45:159-178. https://doi.org/10.1016/S0167-9473(02)00343-2
Kirchhof P, Sipido KR, Cowie MR, et al. The continuum of personalized cardiovascular medicine: a position paper of the European Society of Cardiology. Eur Heart J. 2014;35(46):3250-3257. https://doi.org/10.1093/eurheartj/ehu312
Kjaergaard J, Akkan D, Iversen KK, Køber L, Torp-Pedersen C, Hassager C. Right ventricular dysfunction as an independent predictor of short- and long-term mortality in patients with heart failure. Eur J Heart Fail J Work Group Heart Fail Eur Soc Cardiol. 2007;9(6-7):610-616. https://doi.org/10.1016/j.ejheart.2007.03.001
Iacoviello M, Citarelli G, Antoncecchi V, et al. Right ventricular longitudinal strain measures independently predict chronic heart failure mortality. Echocardiography. 2016;33(7):992-1000. https://doi.org/10.1111/echo.13199
Morris DA, Krisper M, Nakatani S, et al. Normal range and usefulness of right ventricular systolic strain to detect subtle right ventricular systolic abnormalities in patients with heart failure: a multicentre study. Eur Heart J Cardiovasc Imaging. 2017;18(2):212-223. https://doi.org/10.1093/ehjci/jew011