Echocardiographic right ventricular strain analysis in chronic heart failure
Erwan Donal1, Manuel Roulaud, Pascale Raud-Raynier
1Department of Cardiology, University Hospital, CCP- CHU Pontchaillou, 35000 Rennes, France. erwan.donal@chu-rennes.fr
Summary
Right ventricular (RV) function, measured by longitudinal systolic strain (epsilon), is a reliable and stronger predictor of major adverse cardiac events in heart failure (HF) patients than cardiopulmonary exercise testing (CPET) or brain natriuretic peptide (BNP).
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Heart failure (HF) management requires accurate prognostic indicators.
- Right ventricular (RV) dysfunction is common in HF and impacts outcomes.
- Current prognostic tools include cardiopulmonary exercise testing (CPET) and brain natriuretic peptide (BNP).
Purpose of the Study:
- To evaluate the added prognostic value of RV longitudinal systolic strain (epsilon) in HF patients.
- To compare the predictive capabilities of RV strain, CPET, and BNP for clinical outcomes.
Main Methods:
- 19 patients with New York Heart Association (NYHA) class III-IV HF underwent echocardiography, CPET, and BNP measurement.
- RV longitudinal systolic strain (epsilon) was assessed using tissue Doppler echocardiography.
- Clinical outcomes, including major adverse cardiac events (MACE), were monitored over 6 months.
Main Results:
- RV strain (epsilon) correlated significantly with BNP, CPET parameters (VE/VCO2 slope, peak VO2, workload), and MACE.
- Patients experiencing MACE had significantly higher BNP, higher VE/VCO2 slope, and lower RV strain (epsilon) compared to MACE-free patients.
- Multivariate analysis identified RV strain (epsilon) as the sole independent predictor of MACE.
Conclusions:
- RV longitudinal systolic strain (epsilon) is a reliable and easily measurable parameter in HF patients.
- RV strain provides stronger prognostic information for MACE than CPET or BNP.
- Epsilon assessment offers a valuable tool for risk stratification in heart failure.
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