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Updated: Aug 30, 2026
Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
Ventricular long axis function is predictive of outcome in patients with chronic heart failure secondary to
Rajaa Faris1, Michael Y Henein, Andrew J S Coats
1Department of Clinical Cardiology, National Heart & Lung Institute, The Royal Brompton Hospital, Dovehouse Street, London SW3 6LY, U.K. rajaa_faris18@hotmail.com
Insights
Sequential increases in left ventricular (LV) long axis function improve prognosis in idiopathic dilated cardiomyopathy (DCM) patients. This offers a new way to estimate survival, especially for those with moderate LV ejection fraction (LVEF) impairment.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Ventricular long axis function shows prognostic value in heart failure.
- Its independent predictive ability over LVEF and functional status requires clarification.
- Prognostic importance of sequential changes in long axis function in idiopathic DCM is unknown.
Purpose of the Study:
- To assess if sequential changes in ventricular long axis function provide additional prognostic information in idiopathic DCM.
- To determine the prognostic importance of longitudinal changes in long axis function over time.
Main Methods:
- Prospective follow-up of 299 idiopathic DCM patients.
- Echocardiographic evaluation of ventricular long axis function at baseline, 1, and 2 years.
- Analysis of mortality and cardiac transplantation rates.
Main Results:
- Absolute RV and LV long axis function values were related to mortality in univariate analysis.
- Sequential increase in LV long axis function independently predicted better prognosis.
- Patients with increased LV long axis function had significantly better survival.
Conclusions:
- Sequential increase in long axis function predicts significantly better survival in idiopathic DCM.
- This finding offers a novel method for prognosis estimation in DCM patients with moderate LVEF impairment.
Background:
Ventricular long axis function has recently been proved to be of prognostic value in patients with heart failure. However, it remains unclear whether it can provide additional independent information over that provided by conventionally used LVEF or functional status. We conducted this study to address this issue, and to determine the prognostic importance of sequential change in long axis function over time in patients with idiopathic DCM.
Material/Methods:
We prospectively followed up 299 DCM patients with mean age of 55.5 years and LVEF of 41%. All patients underwent a complete clinical and echocardiographic evaluation including ventricular long axis function at baseline, 1- and 2-year follow-up.
Results:
At the end of study, 50 patients died and 6 underwent cardiac transplantation. The majority of deaths occurred before the second examination. In univariate analysis, the absolute values of RV and LV long axis functions at the second examination were significantly related to mortality. In multivariate regression model, they did not maintain their prognostic values. However, a sequential increase in the LV long axis function significantly predicted prognosis, independently of age, NYHA class, and exercise tolerance. The subsequent survival of patients with increased LV long axis function was significantly better than those with either a decrease or no change in it.
Conclusions:
This study clearly indicates that the sequential increase of long axis function was related to significantly better survival in idiopathic DCM patients, which provides a novel method to estimate prognosis of these patients with moderate impairment of LVEF at initial presentation.
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