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Assessing Right Ventricular Dysfunction in Patients with Reduced and Midrange Ejection Fraction: An Echocardiographic Study on the Biventricular Dysfunction in Heart Failure Patients

Malanchini, F. Sozzi, M. Squillace, E. Gherbesi, M. Schiavone, C. Gobbi, et al., European Heart Journal ( 2018 ) 39 ( Supplement ), 1718

Background: An important determinant of symptoms prognosis in patients with Heart Failure (HF) with both preserved (HFpEF) or reduced (HFrEF) ejection fraction (EF) is the right ventricular systolic dysfunction. Limited data is available on biventricular dysfunction in HF with midrange EF (HFmrEF).

Aim: To assess the relation between left (LV) and right ventricle (RV) systolic function among patients with mrEF and rEF.

Methods: Echocardiographic data of any patient referred for an echocardiographic evaluation in our institution between 1/3/2015 and 31/1/2018 were collected. Patients with LVEF <50% were considered. Standard echocardiographic parameters were analysed in a linear regression model; population was divided in two subgroups and then compared on the basis of LVEF (<40%, 40–49%). Significance level was set to 0.05. Stata 13.0 was used for the analysis.

Results: The identification of 553 patients with mrEF and 398 patients with rEF among 12,778 all comers. Mean EF was found to be 39.4±7.7%, mean tricuspid annular plane systolic excursion (TAPSE) was 20.7±4.2 mm. The two subgroups were similar in terms of height, weight and BMI. The group of patients with HFmrEF has smaller LVEDV (117.6±39.1 vs 150±52.0 ml, p<0.001), smaller left atrial volume (73.4±32.5 vs 86.37±39.0 ml, p<0.001), better right ventricular function (TAPSE 21±4.0 vs 19.6±4.2 mm, p<0.001) and lower systolic Pulmonary Arterial Pressure (sPAP = 34.2±10.8 vs 38.7±13.2 mmHg). Biventricular function indexes correlate in a significant way (beta coeff. 0.16, p<0.001) in all study subjects (Figure) and even more among patients with a reduced EF (beta coeff. 0.29, p<0.001). On the contrary no relation between TAPSE and LVEF was found among patients with mrEF (beta coeff. 0.01, p 0.90).

Conclusions: No correlation between LV and RV systolic function indexes is observed in patients with mrEF, contradictory to what is seen in patients with HFrEF.

Figure: Co-relation of Biventricular Function

Source: ESC 2018 Last Modified :Aug 6, 2019.
Compiled and edited by the Editorial team and approved by Expert panel of CardioValens.com
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