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Updated: Jun 23, 2026
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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
Right ventricular function in patients with preserved and reduced ejection fraction heart failure
Sarinya Puwanant1, Tiffany C Priester, Farouk Mookadam
1Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Summary
Right ventricular dysfunction is common in heart failure with preserved ejection fraction (HFpEF). While present, the severity of RV dysfunction in HFpEF is milder compared to heart failure with reduced ejection fraction (HFrEF).
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Heart failure with preserved ejection fraction (HFpEF) is increasingly recognized, yet the characteristics of right ventricular (RV) involvement remain an area of active investigation.
- Understanding RV function in HFpEF is crucial for comprehensive patient management and risk stratification.
Purpose of the Study:
- To determine the prevalence of RV dysfunction in patients diagnosed with HFpEF.
- To compare the degree of RV dysfunction between patients with HFpEF and those with heart failure with reduced ejection fraction (HFrEF).
Main Methods:
- Prospective enrollment of 100 heart failure patients, with 51 categorized as having HFpEF (left ventricular ejection fraction > 50%).
- Assessment of RV systolic dysfunction using RV fractional area change (FAC), tricuspid annular motion (TAM), and peak systolic tricuspid annular tissue velocity (S').
- Evaluation of diastolic function and filling pressures using tricuspid E/e' and hepatic vein systolic velocities.
Main Results:
- RV systolic dysfunction was prevalent in HFpEF, identified in 33% (FAC), 40% (TAM), and 50% (S') of patients.
- Patients with HFpEF demonstrated significantly better RV function (higher FAC, TAM, S') compared to patients with HFrEF.
- Elevated RV filling pressures (tricuspid E/e' > 6) were observed in 34% of HFpEF patients, with higher diastolic velocities noted compared to HFrEF.
Conclusions:
- RV systolic and diastolic dysfunctions are not uncommon in patients with HFpEF.
- Despite prevalence, the severity of RV dysfunction in HFpEF is generally milder when compared to HFrEF.
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