Right ventricular systolic function for risk stratification in patients with stable left ventricular systolic dysfunction: comparison of radionuclide angiography to echoDoppler parameters

被引：45

作者：

de Groote, Pascal ^{[1
]}

Fertin, Marie ^{[1
,2
,3
]}

Goeminne, Celine ^{[1
]}

Petyt, Gregory ^{[2
,4
]}

Peyrot, Sandrine ^{[1
]}

Foucher-Hossein, Claude ^{[2
,4
]}

Mouquet, Frederic ^{[1
]}

Bauters, Christophe ^{[1
,2
,3
]}

Lamblin, Nicolas ^{[1
,3
]}

机构：

[1] Ctr Hosp Reg & Univ Lille, Hop Cardiol, Serv Cardiol Pole Cardiovasc & Pulm, Lille, France

[2] Univ Lille 2, Fac Med Lille, Lille, France

[3] Univ Lille 2, Inst Pasteur Lille, INSERM, U744, Lille, France

[4] Ctr Hosp Reg & Univ Lille, Serv Med Nucl Pole Imagerie & Explorat Fonct, F-59037 Lille, France

来源：

EUROPEAN HEART JOURNAL | 2012年 / 33卷 / 21期

关键词：

Chronic heart failure; Left ventricular systolic dysfunction; Right ventricular ejection fraction; Prognosis; EJECTION FRACTION; HEART-FAILURE; NATRIURETIC PEPTIDE; PROGNOSTIC VALUE; SURVIVAL; RECOMMENDATIONS; MORTALITY; PRESSURE; OUTCOMES; MOTION;

D O I：

10.1093/eurheartj/ehs080

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Previous studies have demonstrated that the radionuclide right ventricular (RV) ejection fraction (RVEF), tricuspid annular plane systolic excursion (TAPSE), and tissue Doppler peak systolic tricuspid annular velocity (STr) were independent predictors of cardiac survival in stable patients with left ventricular systolic dysfunction (LVSD). No study has compared the prognostic value of these three RV parameters. The aim of this study was to compare the prognostic value of RVEF, TAPSE, and STr in a large group of patients with LVSD. Methods and results We analysed 527 consecutive patients who underwent an extensive prognostic evaluation (clinical data, biological data, radionuclide angiography, echoDopplercardiography, cardiopulmonary exercise test). Tricuspid annular plane systolic excursion and STr were weakly correlated with RVEF (r = 0.20). During a follow-up period of 1268 days (802-1830), there were 121 cardiovascular deaths. Best cut-off values were 37, 9.7 cm/s, and 18.5 mm for RVEF, STr, and TAPSE, respectively. Right ventricular ejection fraction was a powerful independent predictor of cardiac survival [relative risk (RR): 2.05 (1.29-3.26), P = 0.002]. Peak systolic tricuspid annular velocity added a modest prognostic information [RR: 1.56 (1.02-2.39), P = 0.04]. However, the combination of STr with RVEF was the most powerful predictor of cardiovascular death. Tricuspid annular plane systolic excursion was not an independent predictor of cardiac survival. Conclusions Right ventricular systolic function remains a powerful independent predictor of the clinical outcome. Even in the context of a complete echocardiographic assessment, radionuclide RVEF continues to be the most powerful RV systolic parameter for cardiac survival prediction. However, the determination of STr, in addition to RVEF, could improve risk stratification.

引用

页码：2672 / +

页数：9

共 29 条

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