Right Ventricular Longitudinal Strain Measures Independently Predict Chronic Heart Failure Mortality
Massimo Iacoviello1, Gaetano Citarelli2, Valeria Antoncecchi3
1Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Bari, Italy.
Echocardiography (Mount Kisco, N.Y.)
|February 12, 2016
Summary
Two-dimensional speckle tracking measures of right ventricular (RV) global longitudinal strain (RV-GLS) and RV free wall strain (RV-fwLS) can predict mortality in heart failure (HF) patients. These echocardiographic assessments offer valuable prognostic information for managing HF outpatients.
Area of Science:
- Cardiology
- Echocardiography
- Heart Failure Research
Background:
- Assessing right ventricular (RV) function is clinically challenging.
- Two-dimensional (2D) speckle tracking offers novel methods for evaluating RV myocardial deformation.
- Predictive value of RV strain measures in chronic heart failure (HF) requires further investigation.
Purpose of the Study:
- To determine the role of 2D systolic strain measures of the RV in predicting mortality among chronic HF outpatients.
- To assess the prognostic capability of RV global longitudinal strain (RV-GLS) and RV free wall strain (RV-fwLS).
Main Methods:
- 332 stable chronic heart failure outpatients on conventional therapy were enrolled.
- 2D speckle tracking analysis was performed on a RV-focused four-chamber view.
- RV-GLS and RV-fwLS were calculated and correlated with all-cause mortality over a mean follow-up of 36 months.
Main Results:
- A total of 64 deaths occurred during the follow-up period.
- Both RV-GLS and RV-fwLS were significantly associated with all-cause mortality in univariate and multivariate analyses.
- Multivariate analysis showed independent predictive value for RV-GLS (HR: 1.13) and RV-fwLS (HR: 1.07) for mortality.
Conclusions:
- 2D RV strain measures, including RV-GLS and RV-fwLS, independently predict mortality in chronic heart failure patients.
- These echocardiographic parameters demonstrate significant clinical utility in the daily management of HF outpatients.
- 2D speckle tracking provides valuable prognostic insights into RV function in heart failure.
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