Abstract 12830: Prognostic Significance of the Right Ventricular Dimension on Acute Decompensation in Chronic Left-sided Heart Failure
Introduction: Although many reports have shown that right ventricular (RV) function in the compensatory phase has prognostic significance of chronic heart failure (HF), there have been few reports investigating its clinical significance on acute exacerbation.
Methods: One hundred and twenty-three consecutive patients (67±15 yo, 95 men) admitted for dyspnea derived from exacerbated left-sided HF with a left ventricular ejection fraction (LVEF) <40% in 2006–09 were enrolled. Based on our preliminary data of a high correlation between RV volume (r=0.75, p<0.05) or ejection fraction (r=0.63, p<0.05) estimated by cardiac magnetic resonance and RV dimension by conventional echocardiogram, we investigated whether RV end-diastolic dimension (RVDd) on admission and at discharge could predict the long-term prognosis.
Results: There were 14 cardiac deaths during the median follow-up of 422 days after admission. Multivariate analysis revealed that RVDd on admission (hazard ratio 1.109, p<0.05, 95% confidence interval 1.038–1.186), but not RVDd at discharge or LVEF, was an independent predictor of survival. The cardiac-death-free rates significantly decreased according to increasing tertiles of RVDd on admission stratified by the levels of 32 and 40 mm (Figure; p<0.05). The patients demonstrating enlarged RVDd showed significantly higher levels of total bilirubin and decreased pulse pressure, suggesting low cardiac output on admission (p<0.05, respectively).
Conclusion: Enlarged RVDd on HF exacerbation predicted a worse long-term prognosis of left-sided HF presumably through facilitated low cardiac output.
- © 2010 by American Heart Association, Inc.