Abstract 9949: Prognostic Value of Longitudinal Strain of Right Ventricle in Patients With Stable Coronary Artery Disease
Background: Regional strain by speckle tracking echocardiography is an emerging technique and can be used for assessment of right ventricle (RV). The aims of this study were to validate the prognostic value of RV strain as a new index of RV systolic function in patients with stable coronary artery disease.
Methods and Results: We recruited 142 patients receiving elective coronary angiography for suspected coronary artery disease (mean age 64 ± 11 years, 113 men). RV lateral wall strain was measured by using speckle tracking echocardiography from apical 4 chamber view. The median follow-up duration for the entire patient population was 23.07 ± 6.58 months. During the follow-up, 21 patients died and 39 patients reached major adverse cardiovascular events. After excluding non-cardiovascular death, patients who died (18, 12.6%) had lower left ventricular ejection fraction (53.61±12.29 vs. 61.13± 14.27 %, p = 0.03 or greater impairment of RV lateral wall strain (-12.29 ±3.26 vs. -17.42± 5.12%, p = 0.01) compared with survivors. Besides, patients who developed arrhythmia had higher rate of right coronary artery involvement (82.9 vs 51.5 %, p = 0.001) or impaired RV lateral wall strain (-12.29 ±3.26 vs. -17.42 ±5.14 %, p = 0.001). Using -18% as a cutoff point for RV strain, patients with strain ≤ -18 % had superior outcome compared to patients with an RV lateral wall strain > -18 % (log-rank X 2, 9.04 and 6.94 for cardiovascular mortality and arrhythmia events respectively, p = 0.003 for both). After multivariate regression analysis, RV lateral wall strain was an independent prognostic factor for both cardiovascular mortality (hazard ratio 9.24; 95% confidence interval 1.2-71.2; p = 0.03) and arrhythmia (hazard ratio 2.44; 95% confidence interval 1.03-5.8; p = 0.04) (Fig).
Conclusions: RV lateral wall strain by speckle-tracking echocardiography is significantly related to long-term cardiovascular outcome and newly developed arrhythmia of patients with stable coronary artery disease.
- © 2013 by American Heart Association, Inc.