Relationship between right ventricular volumes measured by cardiac magnetic resonance imaging and prognosis in patients with chronic heart failure

Autor: Andrew L. Clark, Huan P. Loh, John G.F. Cleland, Elena I. Lukaschuk, Ann C. Tweddel, Nikolay P. Nikitin, Thanjavur Bragadeesh, Farqad Alamgir, Scot Garg, Christos V. Bourantas, Alan S. Rigby
Rok vydání: 2010
Předmět:
Male
medicine.medical_specialty
Heart Ventricles
Ventricular Dysfunction
Right
Adrenergic beta-Antagonists
Magnetic Resonance Imaging
Cine
Physical examination
Kaplan-Meier Estimate
Ventricular Function
Left
Ventricular Dysfunction
Left
Interquartile range
Cardiac magnetic resonance imaging
Internal medicine
medicine
Odds Ratio
Prevalence
Health Status Indicators
Humans
In patient
Poisson Distribution
Aged
Ultrasonography
Heart Failure
Ejection fraction
medicine.diagnostic_test
Proportional hazards model
business.industry
Stroke Volume
Middle Aged
medicine.disease
Prognosis
United Kingdom
medicine.anatomical_structure
Logistic Models
Heart failure
Multivariate Analysis
Vascular resistance
Cardiology
Disease Progression
Regression Analysis
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: European journal of heart failure. 13(1)
ISSN: 1879-0844
Popis: The aim of this study was to investigate the prognostic impact of right ventricular (RV) size in patients with chronic heart failure.Normal volunteers (n = 80) and patients (n = 380) with left ventricular (LV) ejection fraction45% 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 (P0.0001). 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.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.
Databáze: OpenAIRE
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