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Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
Published on: October 28, 2020
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Right ventricular dysfunction affects survival after surgical left ventricular restoration.
Lotte E Couperus1, Victoria Delgado1, Meindert Palmen2
1Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands.
The Journal of Thoracic and Cardiovascular Surgery
|October 19, 2016
Summary
Right ventricular systolic dysfunction before surgical left ventricular restoration predicts higher mortality in ischemic heart failure patients. Impaired right ventricular function significantly increases the risk of death within 30 days post-surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Left ventricular restoration surgery aims to improve outcomes in ischemic heart failure.
- Prognostic value of right ventricular function in this context remains under-investigated.
Purpose of the Study:
- To assess the prognostic significance of right ventricular (RV) function using echocardiography.
- To determine if RV parameters predict mortality after surgical left ventricular restoration.
Main Methods:
- 139 patients with ischemic heart failure underwent RV function assessment (RV fractional area change, tricuspid annular plane systolic excursion, RV longitudinal peak systolic strain) pre-surgery.
- Association between RV parameters and 30-day all-cause mortality was analyzed, adjusting for left ventricular ejection fraction and aortic crossclamping time.
- The additive impact of multiple impaired RV parameters on mortality was evaluated.
Main Results:
- Impaired RV function was prevalent, with 39% of patients showing at least one echocardiographic sign of dysfunction.
- RV fractional area change, tricuspid annular plane systolic excursion, and RV longitudinal peak systolic strain were independently associated with 30-day mortality.
- The presence of multiple impaired RV parameters significantly increased 30-day mortality risk.
Conclusions:
- Baseline right ventricular systolic dysfunction is an independent predictor of increased mortality.
- Echocardiographic assessment of RV function is crucial for risk stratification in patients undergoing surgical left ventricular restoration.
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