Abstract 3739: Tissue Doppler Echocardiography Assessment of Right Ventricular Systolic Function in Patients with Congestive Heart Failure: Validation with Cardiac Magnetic Resonance
There is limited data to support the use of echocardiogram in clinical assessment of right ventricular (RV) function. Recently consensus has grown on the incremental prognostic value of right ventricular function in patients with advanced heart failure The aim of the study is using right ventricular ejection fraction (RVEF) derived form cardiac magnetic resonance(CMR) as reference to study the accuracy of Tissue Doppler Echocardiography (TDE) in assessment of RV systolic function. Methods: 52 males and 12 females patients, mean age 63.5 +/− 11.1 years, of whom 34 have history of myocardial infarction (MI), 10 have ischemic heart disease without MI and 20 have dilated cardiomyopathy and all have history of congestive heart failure. They underwent echocardiogram and CMR on the same day. Conventional echo measurements as well as TDE of the longitudinal velocity at the lateral tricuspid annulus from apical 4-chambers view were obtained. Correlation of RVEF using Simpson’s rule by CMR was made with different echo parameters. Results: The mean CMR RVEF was 42.3% (range 16.5% − 63.9%). Conventional echocardiogram parameters including, RV systolic and diastolic area, the RV area fractional change, RV short and long axis length, RV myocardial performance index (RIMP) were not significantly correlated with RVEF. TDI measurements of peak systolic (Sa) (p=0.029) but not early diastolic (Ea) or late diastolic (Aa) longitudinal velocity nor ratio of Ea/Sa significantly correlated with RVEF. By receiver operating characteristic (ROC) curve analysis, the cutoff value of Sa <9.5cm/sec predicted RVEF < 45% with 70% sensitivity and 61%. Conclusions: Peak systolic tricuspid annular velocity was a useful indicator of global right ventricular systolic function in patients with congestive heart failure. TDE allows non-invasive bedside assessment for detecting abnormal RV systolic function quantitatively.