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Right ventricular systolic function for risk stratification in patients with stable left ventricular systolic dysfunction: comparison of radionuclide angiography to echoDoppler parameters.
Eur Heart J. 2012 Nov; 33(21):2672-9.EH

Abstract

AIMS

Previous studies have demonstrated that the radionuclide right ventricular (RV) ejection fraction (RVEF), tricuspid annular plane systolic excursion (TAPSE), and tissue Doppler peak systolic tricuspid annular velocity (STr) were independent predictors of cardiac survival in stable patients with left ventricular systolic dysfunction (LVSD). No study has compared the prognostic value of these three RV parameters. The aim of this study was to compare the prognostic value of RVEF, TAPSE, and STr in a large group of patients with LVSD.

METHODS AND RESULTS

We analysed 527 consecutive patients who underwent an extensive prognostic evaluation (clinical data, biological data, radionuclide angiography, echoDopplercardiography, cardiopulmonary exercise test). Tricuspid annular plane systolic excursion and STr were weakly correlated with RVEF (r = 0.20). During a follow-up period of 1268 days (802-1830), there were 121 cardiovascular deaths. Best cut-off values were 37%, 9.7 cm/s, and 18.5 mm for RVEF, STr, and TAPSE, respectively. Right ventricular ejection fraction was a powerful independent predictor of cardiac survival [relative risk (RR): 2.05 (1.29-3.26), P = 0.002]. Peak systolic tricuspid annular velocity added a modest prognostic information [RR: 1.56 (1.02-2.39), P = 0.04]. However, the combination of STr with RVEF was the most powerful predictor of cardiovascular death. Tricuspid annular plane systolic excursion was not an independent predictor of cardiac survival.

CONCLUSIONS

Right ventricular systolic function remains a powerful independent predictor of the clinical outcome. Even in the context of a complete echocardiographic assessment, radionuclide RVEF continues to be the most powerful RV systolic parameter for cardiac survival prediction. However, the determination of STr, in addition to RVEF, could improve risk stratification.

Authors+Show Affiliations

Service de Cardiologie, Pôle Cardio-Vasculaire et Pulmonaire, Hôpital Cardiologique, Boul Prof J Leclercq, Centre Hospitalier Régional et Universitaire de Lille, Lille, France. pdegroote@chru-lille.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22453651

Citation

de Groote, Pascal, et al. "Right Ventricular Systolic Function for Risk Stratification in Patients With Stable Left Ventricular Systolic Dysfunction: Comparison of Radionuclide Angiography to echoDoppler Parameters." European Heart Journal, vol. 33, no. 21, 2012, pp. 2672-9.
de Groote P, Fertin M, Goéminne C, et al. Right ventricular systolic function for risk stratification in patients with stable left ventricular systolic dysfunction: comparison of radionuclide angiography to echoDoppler parameters. Eur Heart J. 2012;33(21):2672-9.
de Groote, P., Fertin, M., Goéminne, C., Petyt, G., Peyrot, S., Foucher-Hossein, C., Mouquet, F., Bauters, C., & Lamblin, N. (2012). Right ventricular systolic function for risk stratification in patients with stable left ventricular systolic dysfunction: comparison of radionuclide angiography to echoDoppler parameters. European Heart Journal, 33(21), 2672-9. https://doi.org/10.1093/eurheartj/ehs080
de Groote P, et al. Right Ventricular Systolic Function for Risk Stratification in Patients With Stable Left Ventricular Systolic Dysfunction: Comparison of Radionuclide Angiography to echoDoppler Parameters. Eur Heart J. 2012;33(21):2672-9. PubMed PMID: 22453651.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Right ventricular systolic function for risk stratification in patients with stable left ventricular systolic dysfunction: comparison of radionuclide angiography to echoDoppler parameters. AU - de Groote,Pascal, AU - Fertin,Marie, AU - Goéminne,Céline, AU - Petyt,Grégory, AU - Peyrot,Sandrine, AU - Foucher-Hossein,Claude, AU - Mouquet,Frédéric, AU - Bauters,Christophe, AU - Lamblin,Nicolas, Y1 - 2012/03/27/ PY - 2012/3/29/entrez PY - 2012/3/29/pubmed PY - 2013/4/20/medline SP - 2672 EP - 9 JF - European heart journal JO - Eur. Heart J. VL - 33 IS - 21 N2 - AIMS: Previous studies have demonstrated that the radionuclide right ventricular (RV) ejection fraction (RVEF), tricuspid annular plane systolic excursion (TAPSE), and tissue Doppler peak systolic tricuspid annular velocity (STr) were independent predictors of cardiac survival in stable patients with left ventricular systolic dysfunction (LVSD). No study has compared the prognostic value of these three RV parameters. The aim of this study was to compare the prognostic value of RVEF, TAPSE, and STr in a large group of patients with LVSD. METHODS AND RESULTS: We analysed 527 consecutive patients who underwent an extensive prognostic evaluation (clinical data, biological data, radionuclide angiography, echoDopplercardiography, cardiopulmonary exercise test). Tricuspid annular plane systolic excursion and STr were weakly correlated with RVEF (r = 0.20). During a follow-up period of 1268 days (802-1830), there were 121 cardiovascular deaths. Best cut-off values were 37%, 9.7 cm/s, and 18.5 mm for RVEF, STr, and TAPSE, respectively. Right ventricular ejection fraction was a powerful independent predictor of cardiac survival [relative risk (RR): 2.05 (1.29-3.26), P = 0.002]. Peak systolic tricuspid annular velocity added a modest prognostic information [RR: 1.56 (1.02-2.39), P = 0.04]. However, the combination of STr with RVEF was the most powerful predictor of cardiovascular death. Tricuspid annular plane systolic excursion was not an independent predictor of cardiac survival. CONCLUSIONS: Right ventricular systolic function remains a powerful independent predictor of the clinical outcome. Even in the context of a complete echocardiographic assessment, radionuclide RVEF continues to be the most powerful RV systolic parameter for cardiac survival prediction. However, the determination of STr, in addition to RVEF, could improve risk stratification. SN - 1522-9645 UR - https://www.unboundmedicine.com/medline/citation/22453651/Right_ventricular_systolic_function_for_risk_stratification_in_patients_with_stable_left_ventricular_systolic_dysfunction:_comparison_of_radionuclide_angiography_to_echoDoppler_parameters_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehs080 DB - PRIME DP - Unbound Medicine ER -