Superior Prognostic Value of Right Ventricular Free Wall Compared to Global Longitudinal Strain in Patients With Heart Failure

2019 ◽  
Vol 32 (7) ◽  
pp. 836-844.e1 ◽  
Author(s):  
Erberto Carluccio ◽  
Paolo Biagioli ◽  
Rosanna Lauciello ◽  
Cinzia Zuchi ◽  
Anna Mengoni ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Ventricular Free Wall ◽  
Free Wall ◽  
Right Ventricular Free Wall ◽  
Patients With Heart Failure

Prognostic value of right ventricular free wall longitudinal strain in a large cohort of outpatients with left-side heart disease

2019 ◽  
Vol 21 (9) ◽  
pp. 1013-1021 ◽  
Author(s):  
Mara Gavazzoni ◽  
Luigi P Badano ◽  
Enrico Vizzardi ◽  
Riccardo Raddino ◽  
Davide Genovese ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Structural Heart Disease ◽  
Ventricular Free Wall ◽  
Free Wall ◽  
Heart Failure Hospitalization ◽  
Right Ventricular Free Wall ◽  
Echocardiographic Parameters

Abstract Aims Right ventricular free wall longitudinal strain (RVFWLS) has been proposed as an accurate and sensitive measure of right ventricular function that could integrate other conventional parameters such as tricuspid annulus plane systolic excursion (TAPSE) and fractional area change (FAC%). The aim of the present study was to evaluate the relationship between RVFWLS and outcomes in stable asymptomatic outpatients with left-sided structural heart disease. Methods and results We enrolled 458 asymptomatic patients with left-side heart diseases and any ejection fraction who were referred for echocardiography to two Italian centres. The composite endpoint of death for any cause and heart failure hospitalization was used as primary outcome of this analysis. After a mean follow-up of 5.4 ± 1.2 years, 145 patients (31%) reached the combined endpoint. Most of echocardiographic parameters were related to outcomes, including right ventricular functional parameters. Mean value of RVFWLS in our cohort was −21 ± 8% and it was significantly related to the combined endpoint and in multivariable Cox-regression model; when tested with other echocardiographic parameters that were significantly related to outcome at univariate analysis, RVFWLS maintained its independent association with outcome (hazard ratio 0.963, 95% confidence interval 0.948–0.978; P = 0.0001). The best cut-off value of RVFWLS to predict outcome was −22% (area under the curve 0.677; P < 0.001; sensitivity 70%; 65% specificity). Conclusion RVFWLS may help clinicians to identify patients with left-sided structural heart disease at higher risk for first heart failure hospitalization and death for any cause.

scholarly journals Right Ventricular Free wall Longitudinal Strain in Heart Failure with Mid-range and Preserved Ejection Fraction. Application and Prognostic Implications.

2021 ◽  
Author(s):  
Daniel Grados-Saso ◽  
Juan Manuel Salvador ◽  
Anyuli Gracia-Gutiérrez ◽  
Jorge Rubio-Gracia ◽  
Juan Ignacio Perez-Calvo ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Cardiovascular Mortality ◽  
Longitudinal Strain ◽  
Left Ventricular ◽  
Ventricular Free Wall ◽  
Free Wall ◽  
Right Ventricular Free Wall ◽  
Prognostic Implications

Abstract Purpose: Right ventricle plays an important role in heart failure with preserved and mid-range ejection fraction. Right ventricular dysfunction is common and associated with increased morbidity and mortality in this population. Quantification of right ventricular functional parameters by echocardiography is challenging. Right ventricular strain represents a tool that can provide useful information in the assessment of RV function, offering information with potential prognostic implications.Methods: In a cohort of 71 prospectively included patients admitted for an episode of heart failure with mid-range and preserved ejection fraction (LVEF >40%) right ventricular function was evaluated through right ventricular free wall longitudinal strain. Left ventricular global longitudinal strain was also calculated. Relationship with variables such as hospital readmission and cardiovascular mortality was studied. Results: Worse right ventricular free wall longitudinal strain was associated to higher probability of cardiovascular mortality at six months. In a multivariate analysis RV free wall strain remained a predictor of cardiovascular mortality at 6 months. Significant linear correlation (p <0.01) was observed between longitudinal deformation indices of both ventricles. Conclusion In patients with heart failure with preserved and mid-range ejection fraction, impairment of right ventricular free wall strain is common and is related to worse clinical outcome (increased cardiovascular mortality at six months) regardless of other right ventricular functional parameters and left ventricular ejection fraction. Therefore, representing a sensitive non-invasive prognostic indicator in these patients, and could be useful in stratifying the risk of adverse events. RV and LV strain are correlated indicating biventricular involvement of deformation parameters with prognostic significance.

scholarly journals Preoperative Right Ventricular Free‐Wall Longitudinal Strain as a Prognosticator in Isolated Surgery for Severe Functional Tricuspid Regurgitation

2021 ◽  
Author(s):  
Minkwan Kim ◽  
Hyun‐Jung Lee ◽  
Jun‐Bean Park ◽  
Jihoon Kim ◽  
Seung‐Pyo Lee ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tricuspid Regurgitation ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Unplanned Readmission ◽  
Free Wall ◽  
Right Ventricular Free Wall ◽  
Surgical Timing ◽  
End Point

Background Severe tricuspid regurgitation (TR) should be intervened before the development of irreversible right ventricular (RV) dysfunction. However, current guidelines do not provide criterion related to RV systolic function to guide optimal surgical timing. We investigated the prognostic value of RV longitudinal strain in patients undergoing isolated surgery for severe functional TR. Methods and Results We enrolled 115 consecutive patients (aged 62±10 years; 23.5% men; 62.6% [n=72] with previous left‐sided valve surgery) who underwent isolated surgery for severe functional TR at 2 tertiary centers. Preoperative clinical and echocardiographic parameters, including RV free‐wall longitudinal strain (RVFWSL), were collected. The primary end point was a composite of cardiac death and unplanned readmission attributable to cardiovascular causes 5 years after surgery. Forty patients (34.8%) reached the primary end point during 333 person‐years of follow‐up. There were 11 cardiac deaths and 34 unplanned readmissions attributable to cardiovascular causes, with 5 patients experiencing both. An absolute preoperative RVFWSL <24% was associated with the primary end point (hazard ratio, 2.30; 95% CI, 1.22–4.36; P =0.011), independent of clinical risk factors, including European System for Cardiac Operative Risk Evaluation II and hemoglobin levels. Meanwhile, other conventional echocardiographic measures of RV systolic function were not significant. The addition of an absolute RVFWSL <24% provided incremental prognostic value to the clinical model for predicting the primary end point. Conclusions Preoperative RVFWSL as an indicator of RV dysfunction was an independent prognosticator in patients undergoing isolated surgery for severe functional TR. Thus, preoperative RVFWSL could help determine the optimal surgical timing for severe functional TR.

scholarly journals THE PROGNOSTIC VALUE OF RIGHT VENTRICULAR FREE WALL STRAIN AFTER LUNG TRANSPLANTATION IN PATIENTS WITH SCLERODERMA

2018 ◽  
Vol 71 (11) ◽  
pp. A1955
Author(s):  
Yuko Soyama ◽  
Marc Simon ◽  
Masataka Sugahara ◽  
Akiko Goda ◽  
Nobuyuki Kagiyama ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Right Ventricular ◽  
Prognostic Value ◽  
Ventricular Free Wall ◽  
Free Wall ◽  
Right Ventricular Free Wall
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