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Right ventricular dysfunction in chronic heart failure patients
Author(s) -
Špinarová Lenka,
Meluzín Jaroslav,
Toman Jiří,
Hude Petr,
Krejčí Jan,
Vítovec Jiří
Publication year - 2005
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.07.017
Subject(s) - medicine , cardiology , heart failure , ejection fraction , systole , diastole , doppler imaging , cardiac catheterization , hemodynamics , blood pressure
Aim To evaluate any differences in haemodynamic and echocardiographic parameters in patients with both left (LV) and right ventricular (RV) systolic dysfunction and in patients with isolated LV systolic dysfunction. Study group One hundred patients with RV systolic dysfunction defined as peak velocity of tricuspid annular motion in systole (Sa)<11.5 cm/s, and 55 patients without RV systolic dysfunction Sa>11.5 cm/s. All patients had LV systolic dysfunction, LV ejection fraction (EF) below 40%, NYHA II–IV. Methods LV diameters, volumes and EF were measured by echocardiography. Patients underwent tissue Doppler imaging (TDI) of tricuspid annular motion with measurement of peak systolic velocity (Sa), peak early (Ea) and peak late (Aa) diastolic velocities. Right heart catheterization was also performed. Results Patients with RV systolic dysfunction did not differ from those without RV systolic dysfunction in terms of LV function. Patients with RV systolic dysfunction had larger RV dimension 30.6±5.8 vs. 33.9±6.7 mm, p <0.002. The patients with RV systolic dysfunction had higher values on right heart catheterization: MPAP 29.6±12.1 vs. 24.9±11.4 mm Hg, p <0.02, PCWP 20.8±10.0 vs. 17.3±9.3 mm Hg, p <0.03, PVR 189.9±123.3 vs. 137.7±94.9 dyn s cm <5 , p <0.008, CVP 7.7±5.6 vs. 5.1±3.9 mm Hg, p <0.002. The patients with RV systolic dysfunction had more pronounced diastolic dysfunction measured by TDI: Ea 9.9±2.3 vs. 11.4±2.5 cm/s, p <0.0001 and Aa 13.1±4.0 vs. 16.5±4.7 cm/s, p <0.7. Conclusion Patients with heart failure and both left and right ventricular systolic dysfunction showed more serious findings on central haemodynamics as well as more pronounced right ventricular diastolic dysfunction than those with isolated left ventricular systolic dysfunction.