Relationship between right ventricular volumes measured by cardiac magnetic resonance imaging and prognosis in patients with chronic heart failure.
Eur J Heart Fail
; 13(1): 52-60, 2011 Jan.
Article
in En
| MEDLINE
| ID: mdl-20930000
ABSTRACT
AIMS:
The aim of this study was to investigate the prognostic impact of right ventricular (RV) size in patients with chronic heart failure. METHODS ANDRESULTS:
Normal volunteers (n = 80) and patients (n = 380) with left ventricular (LV) ejection fraction <45% on echocardiography and on optimal treatment for heart failure underwent cardiac magnetic resonance imaging with measurement of LV and RV volumes, mass and ejection fraction. The mean and the standard deviation (SD) of the RV end-systolic volume index in normal subjects were used to define the normal range as mean RV end-systolic volume index +2 SD. Patients with dilated RV (>2 SD beyond the mean) (25%) had more frequent evidence of fluid overload in clinical examination and greater LV dimensions (P < 0.0001). During follow-up (median 45, interquartile range 28-66 months), 37% of patients with and 24% without RV dilation died (log-rank test = 8.4; P = 0.004). In a multivariable Cox regression model, including 13 other clinical variables, RV (HR 1.08/10 mL/m(2), 95% CI 1.00-1.18, P = 0.044), but not LV, end-systolic volume index predicted a worse outcome.CONCLUSION:
Twenty-five per cent of patients with heart failure due to LV systolic dysfunction have a dilated right ventricle. Greater RV dimensions predict mortality in patients with chronic heart failure. Treatments aimed at preserving or enhancing RV structure and function, possibly by unloading the RV by reducing pulmonary vascular resistance or left atrial pressure, should be investigated.
Full text:
1
Database:
MEDLINE
Main subject:
Ventricular Dysfunction, Right
/
Ventricular Dysfunction, Left
/
Magnetic Resonance Imaging, Cine
/
Heart Failure
/
Heart Ventricles
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prevalence_studies
/
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Year:
2011
Type:
Article