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European Journal of Echocardiography Advance Access originally published online on May 13, 2009
European Journal of Echocardiography 2009 10(6):733-737; doi:10.1093/ejechocard/jep052
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Right ventricular function in patients with preserved and reduced ejection fraction heart failure

Sarinya Puwanant, Tiffany C. Priester, Farouk Mookadam, Charles J. Bruce, Margaret M. Redfield and Krishnaswamy Chandrasekaran*

Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

Received 10 January 2009; accepted after revision 16 April 2009; online publish-ahead-of-print 13 May 2009.

* Corresponding author: Department of Medicine, Mayo Clinic, 13400 E Shea Blvd/3A, Scottsdale, AZ 85260, USA. E-mail address: kchandra{at}mayo.edu


  Abstract

Aims: To determine the prevalence of right ventricular (RV) dysfunction in patients with preserved left ventricular (LV) ejection fraction (EF) heart failure (HF) and to compare RV function between patients with preserved EF HF and those with reduced EF HF.

Methods and results: Hundred patients (72 ± 14 years, 59% male) with HF were prospectively enrolled. Fifty-one had preserved EF HF (LVEF > 50%). The prevalence of RV systolic dysfunction in patients with preserved EF HF was 33, 40, and 50%, by using RV fractional area change (FAC), tricuspid annular motion (TAM), and peak systolic tricuspid annular tissue velocity (S') criteria, respectively. Tricuspid S' and TAM correlated the best with LVEF (r = 0. 48, P < 0.01). Patients with preserved EF HF had higher RV FAC (54 ± 18 vs. 36 ± 20%, P < 0.01), TAM (17 ± 1 vs.11 ± 1 mm, P < 0.01), and tricuspid S' (14 ± 6 vs. 9 ± 4 cm/s, P < 0.01) compared with those with reduced EF HF. Of those 51 patients, 34% had tricuspid E/e' > 6 suggestive of elevated RV filling pressures. Early tricuspid inflow (E), early diastolic tricuspid annular tissue (e'), tricuspid E/e', and hepatic vein systolic velocities were also higher in patients with preserved EF HF.

Conclusion: The prevalence of RV systolic and diastolic dysfunctions was not uncommon in patients with preserved EF HF. However, patients with preserved EF HF had milder degree of RV systolic and diastolic dysfunctions compared with those with reduced EF HF.

Keywords: Right ventricle; Heart failure; Dysfunction; Preserved ejection fraction; Echocardiography


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