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Prognostic value of RV isovolumic acceleration and tissue strain in moderate HF r EF
Author(s) -
Sciatti Edoardo,
Vizzardi Enrico,
Bonadei Ivano,
Curnis Antonio,
D'Aloia Antonio,
Metra Marco
Publication year - 2015
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.12505
Subject(s) - medicine , cardiology , heart failure , ejection fraction , subclinical infection , context (archaeology) , receiver operating characteristic , adverse effect , doppler imaging , logistic regression , blood pressure , paleontology , diastole , biology
Background Right ventricular ( RV ) dysfunction in heart failure ( HF ) with reduced left ventricular ejection fraction ( LVEF ) is associated with a poorer prognosis. No studies to date have investigated the prognostic utility of RV isovolumic acceleration ( IVA ) measured at tissue Doppler imaging ( TDI ) in HF . RV strain instead has been already correlated to a poorer prognosis in these patients. We aimed to assess the predictive value of both parameters in this context. Materials and methods Sixty patients enrolled, NYHA II–III. Everyone underwent echocardiographic examination including TDI and strain analysis. Adverse event was defined as cardiovascular death or rehospitalization. Results Follow‐up was 32 ± 13 months. Sixteen patients (26·7%) had an adverse event. IVA and RV strain were significantly lower in these patients. At logistic regression, they were both related to adverse event and their receiver operating characteristic ( ROC ) curve predictive (area under ROC 0·916 and 0·952, respectively). Kaplan–Meier survival curves were significantly worse for both parameters inferior to their respective means ( P < 0·001 for both). Univariate and multivariate analyses confirmed their better utility than tricuspid annular plane systolic excursion ( TAPSE ), fractional area change ( FAC ) or S’ at TDI . Conclusions our study demonstrated a useful prognostic role of RV strain and IVA , which are parameters of subclinical RV impairment. Patients with low values may benefit from a more aggressive therapy and a closer follow‐up.