Abstract 13113: Influence of Right Ventricular Function on Heart Failure Onset in Cases With Preserved Left Ventricular Systolic Function
Background: In recent years, it has been reported that right ventricular function is one of the factors affecting prognosis in patients with HF with reduced EF; however, clinical significance of right ventricular function in patients without reduced EF has not been clarified. In this study, we investigated how right ventricular function affects HF onset in cases without left ventricular systolic dysfunction.
Methods: Subjects comprised 225 cases (108 males, 73+/-12 years) with preserved LVEF. All cases underwent echocardiography and the following indexes were assessed: LVEF, E/e, left ventricular mass index (LVMI). Right ventricular function was assessed with tricuspid annular plane systolic excursion (TAPSE) and tricuspid valve lateral annular systolic velocity (TVS). All cases were classified into three groups with clinical and echocardiography findings: HF group (82 cases), preclinical HF group (E/e>10, 68 cases) and normal group (E/e<10, 75 cases). The association between HF onset and right ventricular function was also investigated.
Results: The prevalence of atrial fibrillation, diabetes mellitus, and chronic kidney disease (CKD) was higher in HF group (p<0.0001, p=0.017 and p<0.0001, respectively). NT-proBNP was also increased with HF severity (p<0.0001). Echocardiography revealed larger left atrial diameter (p=0.0002) and higher LVMI (p<0.0001) in the HF group. E/e’ increased with HF severity (p<0.0001), whereas LVEF was the comparable among three groups. In terms of the relationship between right ventricular function and HF, both TAPSE (p<0.0001) and TVS (p=0.001) significantly decreased with HF severity. Lower TAPSE as well as TVS were significantly related to HF onset in univariable analysis (TAPSE, p<0.0001; TVS, p=0.0003). The relationship between TAPSE and HF onset was still significant after adjustment for confounding factors including age, sex, coronary risk factors, CKD and LVEF.
Conclusions: Our results indicated that right ventricular function was related to HF onset in cases with preserved left ventricular systolic function. TAPSE is measured easily and may be useful marker in treatment of heart failure even in patients without reduce LV systolic function.
- © 2013 by American Heart Association, Inc.