Abstract 12222: Right Ventricular Systolic Dysfunction Predicts Adverse Outcome in Dilated Cardiomyopathy
Introduction: Cardiovascular Magnetic Resonance (CMR) is the “gold-standard” technique for assessment of ventricular function. Although LV volumes and ejection fraction (EF) are powerful predictors of outcome in dilated cardiomyopathy (DCM), there is limited data regarding the significance of RV systolic dysfunction. We hypothesized that CMR assessment of RV function has independent prognostic value in DCM.
Methods: Patients with DCM were studied between Jan 2002-Dec 2006. Patients with significant lung disease, intracardiac shunts or significant coronary artery disease were excluded. Ventricular volumes and EF were assessed from a 3D acquisition using CMR tools (London, UK). RV systolic dysfunction was defined by an RVEF <45%. The primary endpoint was cardiovascular mortality. The secondary endpoint was cardiovascular mortality and heart failure hospitalization.
Results: One hundred and seven patients (72 male, median age 50yrs) were followed up for a median duration of 76 months. RV systolic dysfunction was present in 32 (30%) patients. Cardiovascular death occurred in 17 (16%) patients. Kaplan-Meier analysis demonstrated that RV systolic dysfunction was a significant predictor of the primary (p<0.001) (Fig.1) and secondary (p<0.001) endpoints. After adjustment for NYHA Class and LVEF, RV systolic dysfunction remained a significant independent predictor of cardiovascular mortality (HR 4.13, CI 1.08 to 15.8; p = 0.038) on Cox regression multivariate analysis.
Conclusions: RV systolic dysfunction occurred in 30% of our DCM cohort and is a significant independent predictor of adverse prognosis. CMR assessment of RV function is therefore important in the evaluation and risk stratification of DCM patients.
- © 2010 by American Heart Association, Inc.