Grading right ventricular dysfunction in left ventricular disease using echocardiography: a proof of concept using a...

Area of Science:

• Cardiology
• Echocardiography
• Heart Failure

Background:

• Right ventricular dysfunction (RVD) grading in left ventricular (LV) disease is understudied.
• Accurate RVD assessment is crucial for heart failure management and prognosis.

Purpose of the Study:

• To establish a novel echocardiographic RVD score.
• To evaluate the score's correlation with RVD severity determined by right heart catheterization.
• To compare the novel score's performance against traditional echocardiographic parameters.

Main Methods:

• Developed a 5-point echocardiographic RVD score incorporating pulmonary hypertension, RV strain, RV area, tricuspid regurgitation, and right atrial pressure.
• Included 95 patients with LV disease undergoing heart transplant or heart failure work-up.
• Compared RVD score increments with right heart catheterization data, including RV end-diastolic pressure and RV-PA coupling.

Main Results:

• Higher RVD scores correlated significantly with increased RV end-diastolic pressure and signs of RV-arterial uncoupling (P < 0.001).
• The RVD score demonstrated superior accuracy (AUC 0.88) in detecting severe RVD compared to RV strain, TAPSE, and FAC.
• An RVD score ≥ 4 indicated a 6.7-fold increased likelihood of severe RVD.

Conclusions:

• The novel echocardiographic RVD score effectively grades RVD severity in LV disease patients.
• This score outperforms traditional longitudinal parameters for RVD assessment.
• The RVD score has potential for refined diagnosis, follow-up, and prognosis in heart failure.