Abstract 14770: Latent Right Ventricular Myocardial Dysfunction in Patient With Heart Failure With Preserved Ejection Fraction and Preclinical Diastolic Dysfunction
Background and Purpose: Little is known about right ventricular (RV) dysfunction in heart failure (HF) with preserved ejection fraction (HFpEF) and preclinical diastolic dysfunction. The purpose of our study was to evaluate RV myocardial function of patients with asymptomatic diastolic dysfunction (DD), that of symptomatic DD patients, and to compare them to that of normal subject.
Methods: We enrolled 198 patients with preserved ejection fraction (LVEF≧50%, 96 females, 63±15years) in this study. All subjects underwent standard echocardiography including RV assessment; tricuspid annular plain systolic excursion (TAPSE), fractional area change (FAC) and pulsed Doppler peak velocity at the annulus (s’). Our exclusion criteria were as follows, atrial fibrillation, device implantation, significant aortic or mitral valve disease, history of cardiac surgery, cardiac shunt and pulmonary hypertension. We classified the patients into 3 groups according to septal e’ and symptom of heart failure; normal group (e’≧8), preclinical DD group (e’<8, asymtomatic) and clinical DD group (e’<8, symptomatic).
Results: Normal group, preclinical DD group and clinical DD group consisted of 38 (19%), 116 (59%) and 44 (22%), respectively. Prevalence of DM was 16%, 34% and 30%, prevalence of hypertension was 21%, 63%, and 84%, respectively. In preclinical DD and clinical DD group, Left atrial volume index (p=0.003) and E/e’ ratio (p<0.00001) were significantly larger than those of normal group. In clinical DD group, TRPG (p=0.00001) and estimated systolic pulmonary artery pressure (p=0.01) were significantly larger than other groups, TAPSE was significantly smaller (p=0.0055), FAC and s’ were smaller than other groups, but they were not significant.
Conclusion: Patient with HFpEF has reduced RV myocardial function compared to normal subjects and patient with preclinical DD. And also RV function may be reduced even in patient with preclinical DD.
- © 2013 by American Heart Association, Inc.