Aetiology and outcomes of severe right ventricular dysfunction

Area of Science:

• Cardiology
• Echocardiography
• Pulmonary Medicine

Background:

• Right ventricular dysfunction (RVD) is a critical factor in patient outcomes across various diseases.
• Epidemiological data and survival outcomes for severe RVD are limited.
• This study investigates the characteristics, causes, and survival rates of patients with severe RVD.

Purpose of the Study:

• To examine the epidemiology and aetiology of severe right ventricular dysfunction (RVD).
• To determine the survival outcomes for patients diagnosed with severe RVD.
• To identify factors influencing prognosis in severe RVD.

Main Methods:

• Retrospective analysis of 1299 patients with severe RVD diagnosed via transthoracic echocardiography (TTE) between 2011-2015.
• Exclusion of patients with prior cardiac surgery, mechanical assist devices, or congenital heart disease.
• All-cause mortality as the primary endpoint, with follow-up for survival rates based on RVD aetiology.

Main Results:

• The prevalence of severe RVD was 4% among 64,728 TTE patients.
• Common causes included left-sided heart disease (46%), pulmonary thromboembolic disease (18%), chronic lung disease (CLD; 17%), and pulmonary arterial hypertension (PAH; 11%).
• One-year and five-year survival rates were 61% and 35% respectively. Survival varied significantly by aetiology, with CLD having the poorest prognosis (1-year: 42%, 5-year: 8%).

Conclusions:

• One-year mortality for severe RVD is substantial (~40%) and strongly linked to the underlying cause.
• Left-sided heart disease is the most frequent cause of severe RVD.
• Chronic lung disease (CLD) represents the most challenging aetiology for severe RVD, associated with significantly worse survival outcomes.