Abstract 4866: Impact of Right Ventricular Function on Long-term Survival of Patients with Left Ventricular Dysfunction
The success of cardiac resynchronization therapy as a treatment for heart failure has focused increased attention on the importance of right ventricular (RV) function in patients with left ventricular (LV) dysfunction. In this study, the impact of RV function on long-term survival in patients with LV dysfunction was examined. 1295 patients (97% male; mean age 64.5) with LVEF<50% on clinical radionuclide ventriculography (RNVG) performed from 1986 –1994 were reviewed. RV function was visually assessed on the 3-view RNVG as Normal, Mildly Reduced, Moderately Reduced, or Severely Reduced. Survival status was analyzed using Kaplan-Meier curves, with patients divided into 3 groups based upon LV function: LV1: LVEF≤20%; LV2: LVEF 21–35%; and LV3: LVEF 36 – 49%. During follow-up, 1179 patients (91%) died, with median survival as follows: LV1 (n=199): 26 months; LV2 (n=487): 43 months; LV3 (n=609): 53 months (p<0.0001 overall). For LV1, RV function had no significant effect on survival: median survival was 33 and 31 months for Normal and Severely Reduced respectively. For LV3, although there was better early survival in patients with Normal/Mildly Reduced RV function (median survival 53 mo vs 39 mo for Moderate/Severely Reduced), there was no significant difference in survival during the total follow-up period. For LV2, survival was significantly longer in patients with Normal and Mildly Reduced RV function (table⇓). While long-term survival was strongly influenced by the severity of LV dysfunction, the primary impact of RV function was in patients with moderately severe LV dysfunction (LVEF 21–35%). These findings suggest that efforts to improve RV function may be most beneficial in patients with intermediate severity of LVEF dysfunction.