Abstract 14853: Right Ventricular Function is Associated with Long Term Survival in Patients Undergoing Cardiac Resynchronization Therapy
Introduction: Recent studies have described right ventricular (RV) dysfunction as an independent prognostic factor in patients with moderate to severe heart failure.
Hypothesis: Our aim was to test the hypothesis that baseline RV function in heart failure patients before cardiac resynchronization therapy (CRT) is associated with long term survival.
Methods: We studied 78 heart failure patients with routine indications for CRT according to current guidelines: QRS width ≤120 ms, left ventricular (LV) ejection fraction (EF) <35%. RV function was assessed at baseline by two-dimensional echocardiograhy fractional area change (FAC) and tricuspid annular plane systolic excursion (TAPSE). Outcome events were predefined as all cause mortality, heart transplantation, or LV assist device (LVAD) over 4 years follow-up.
Results: Of the 78 CRT patients, mean age was 65±11 years, 53 were men (68%), 45 had ischemic disease (58%), with LV EF 24±5%, and QRS width 159±26 ms. Over a 4 years follow-up there were 32 events (24 deaths, 4 transplants and 4 LVAD implants). RV FAC <26% was the best cut-off to predict a poor outcome, with 78% specificity and 42% sensitivity and an area under the curve (AUC) = 0.7 (0.55-0.81), p=0.02. The hazard ratio (HR) was 2.4 (95% Confidence Interval 0.9-5.0). TAPSE <11 mm predicted poor survival with 82% specificity and 30% sensitivity, AUC = 0.63 (0.51-0.73), p=0.04; HR = 2.5 (0.7-8.4), p=0.04.
Conclusion: Quantitative assessment of RV function at baseline before CRT with conventional 2D echocardiographic methods may help to further predict long term survival after CRT.
Author Disclosures: A. Delgado-Montero: None. B. Tayal: None. K. Ryo: None. A. Goda: None. D. Schwartzman: Research Grant; Modest; Medtronic, Boston Scientific. S. Saba: Research Grant; Modest; Medtronic, Boston Scientific, St Jude Medical. J. Gorcsan: Research Grant; Modest; Biotronik, GE, Toshiba, Medtronic, St Jude Medical.
- © 2014 by American Heart Association, Inc.