Right ventricular systolic echocardiographic parameters in dilated cardiomyopathy and prognosis.

BACKGROUND: Right ventricular (RV) dysfunction is associated with poor prognosis in patients with non-ischemic dilated cardiomyopathy. Several RV echocardiographic parameters have been proposed as sensitive markers to detect patients at risk. OBJECTIVE: To compare the predictive value of echographic parameters of RV systolic function for adverse outcomes in patients with non-ischemic dilated cardiomyopathy. METHODS:    Forty patients with non-ischemic dilated cardiomyopathy were included. Right ventricular systolic function assessed by Doppler echocardiography standard (RV fractional area change, Tei index, TAPSE and dp/dt), tissue Doppler (peak systolic velocity (Sa)) and Strain 2D of the RV. The primary endpoint was the occurrence of a major cardiovascular event. The follow-up extended for 6.2 months ± 2,49. RESULTS: Eighteen patients reached the primary endpoint. TAPSE (HR 0.86 [0.74-0.99], p=0.04), Sa (HR 0.77 [0.62-0.95], p=0.01), Tei index (HR 1.06 [1.01-1.12], p=0.02) and strain of the lateral wall of the RV (HR 1.13 [1.04-1.23], p=0.004) were found to be independent predictors of major cardiovascular event. The cut-off thresholds for TAPSE, Sa, Tei index and strain of the lateral wall of th RV, defined using ROC curves were respectively 12,5mm ; 8,5cm/s ; 0,55 et -12. CONCLUSION: TAPSE, Sa, Tei index and strain of the lateral wall of the RV are independent predictors of major cardiovascular event in non ischemic dilated cardiomyopathy.