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[Prognostic significance of radionuclide-assessed right ventricular function in dilated cardiomyopathy]
A Ohno1, T Nishimura, T Uehara
1Department of Radiology, National Cardiovascular Center, Suita, Japan.
Insights
Right ventricular ejection fraction (RVEF) is a significant predictor of survival in dilated cardiomyopathy (DCM) patients. Radionuclide assessment of RVEF offers valuable prognostic insights for DCM, outperforming left ventricular ejection fraction (LVEF).
Area of Science:
- Cardiology
- Nuclear Medicine
- Medical Imaging
Background:
- Dilated cardiomyopathy (DCM) is a significant cause of heart failure.
- Prognostic markers for DCM are crucial for patient management.
- The role of right ventricular function in DCM prognosis requires further clarification.
Purpose of the Study:
- To evaluate the prognostic significance of right ventricular ejection fraction (RVEF) in patients with dilated cardiomyopathy (DCM).
- To compare the predictive value of RVEF with other clinical and echocardiographic parameters, including left ventricular ejection fraction (LVEF).
Main Methods:
- A cohort of 57 DCM patients underwent radionuclide assessment.
- Multivariate regression analysis and Kaplan-Meier survival curves were used for prognostic evaluation.
- Key parameters assessed included RVEF, LVEF, mean pulmonary artery pressure (PA), and clinical factors.
Main Results:
- RVEF (p < 0.05) and mean PA showed significant predictive value for survival, while LVEF did not.
- Patients with RVEF < 45% had a poorer survival rate compared to those with RVEF ≥ 45%.
- Lower RVEF correlated with lower LVEF and left ventricular end-systolic volume index (LVESVI).
Conclusions:
- Radionuclide assessment of RVEF is valuable for prognostic evaluation in DCM patients.
- RVEF provides prognostic information independent of, and potentially superior to, LVEF.
- RVEF's predictive value may be influenced by pulmonary artery pressure and left ventricular parameters.
Abstract:
To assess the prognostic significance of right ventricular function in dilated cardiomyopathy (DCM), we studied consecutive 57 DCM patients. There were 41 men and 16 women, whose mean age was 48 ys. (range 3-68 ys.). The mean LVEF in all patients was 29 +/- 11%, and the mean interval from the onset of symptom of cardiac failure (CHF history) was 4 ys. (range 0-33 ys.). With follow-up of 3.8 ys., five patients had died until the first year, and 14 had died until the third year. By using multivariate regression analysis, there were no prognostic significance in clinical parameters such as age, CHF history, sex, atrial fibrillation, except for NYHA class, and medication at the third year. In survival curves according to Kaplan-Meier method, RVEF and mean PA had predictive value (p less than 0.05), while LVEF did not. The patients with RVEF less than 45% had poor survival rate compared to those with RVEF greater than or equal to 45%. The patients with RVEF less than 45% showed lower LVEF and LVESVI. RVEF may offer prognostic predictive value through the effect of not only mean PA but also left ventricular parameter. In conclusion, radionuclide assessment of right ventricular function should be valuable for the prognostic evaluation of DCM patients.