Reduced right ventricular ejection fraction as a marker for idiopathic dilated cardiomyopathy compared with ischemic...

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Heart Failure Research

Background:

• Emerging evidence highlights the role of right ventricular (RV) function in heart failure across various etiologies.
• Studies in idiopathic dilated cardiomyopathy (IDC) reveal high rates of RV dysfunction, often independent of pulmonary hypertension severity.

Purpose of the Study:

• To investigate and compare the role and prevalence of RV dysfunction in patients with ischemic heart failure (coronary artery disease, CAD) versus non-ischemic heart failure (IDC).

Main Methods:

• Invasive hemodynamic and angiographic assessment of 153 patients with left ventricular (LV) dysfunction (ischemic vs. IDC).
• Quantification of RV volumes and ejection fractions, alongside LV ejection fraction and LV/RV end-diastolic volume ratio.
• Comparison of RV dysfunction (RV ejection fraction <35%) and ventricular concordance (<10% RV/LV ejection fraction difference) between groups using logistic regression.

Main Results:

• Patients with IDC and CAD had similar LV ejection fractions and pulmonary pressures, but significantly lower RV ejection fraction in IDC (33% vs. 46%, P <.0001).
• Prevalence of RV dysfunction was markedly higher in IDC (65%) compared to CAD (16%) (P <.0001).
• Reduced RV ejection fraction independently predicted IDC (OR 0.91, P <.0001) with high predictive values for diagnosis.

Conclusions:

• Reduced RV ejection fraction serves as a potent marker for IDC versus CAD in patients with LV dysfunction, irrespective of other clinical factors.
• These findings support the concept of biventricular involvement in IDC, with RV dysfunction being a distinguishing feature.