Research Article
Volume 9 Issue 3 - 2022
Prognostic Impact of Right Ventricle Dysfunction and Associated Echocardiographic Data in Heart Failure Patients with Reduced Ejection Fraction
Hanane Mechal*, Meryem Haboub, Meriem Elmoussaid, Karim Mounaouir, Mohamed El Ghali Benouna, Abdenacer Drighil, Leila Azzouzi and Rachida Habbal
Department of Cardiology, Ibn Rochd University Hospital, Casablanca, Morocco
*Corresponding Author: Hanane Mechal, Department of Cardiology, Ibn Rochd University Hospital, Address, Casablanca, Morocco.
Received: January 09, 2022; Published: January 28, 2022




Abstract

Introduction: There is growing attention for the study of the right ventricle (RV) in heart failure (HF). Right ventricular dysfunction (RVD) is an important predictor of impaired prognosis. Echocardiography is the most performed imaging modality to evaluate HF patients.

Methods: It’s a transversal retrospective study conducted between May 2006 and June 2020 including all patients with HF with reduced ejection fraction (HFrEF), followed-up in the therapeutic unit of HF of our department. We studied 2 groups of patients: group 1 with impaired and group 2 with preserved RV systolic longitudinal function.

Results: Among 3412 patients, 1312 (38.5%) patients had impaired longitudinal systolic RV function (group 1) and 2100 had preserved systolic longitudinal RV function (group 2). Regarding etiologies of HFrEF: ischemic heart disease was represented in 54.9% versus 61%, dilated cardiomyopathy in 9.9% versus 10.5%, valvar hear disease in 4.7% versus 3%, chemotherapy induced cardiomyopathy in 2.4% versus 1.5%, peripartum cardiomyopathy (PPCM) in 0.4% versus 0.3%, tach cardiomyopathy in 0.3% versus 0.3% (p = 0.001). Cardiovascular risk factors accounted for 41.7% versus 37.1% (p = 0.007) for hypertension, 32.6% vs 29% (p = 0.023) for diabetes mellitus, 14.4% vs 7.1% (p < 0.001) for dyslipidemia, and 35.6% vs 29.9% (p < 0.001) for tobacco use. For comorbidities: Chronic obstructive pulmonary disease (COPD) was represented in 3.3% versus 1.7% (p = 0.004). Group 1 patients were more symptomatic according to NYHA classification and had more right-sided HF symptoms. 12.1% vs 8.8% were in atrial fibrillation (p < 0.001). For echocardiographic data: mean LVEF was 30.36 ± 7.41% vs 42.75 ± 6.80% (p < 0.001), significant functional tricuspid regurgitation was present in 11.3% vs 4.2% (p < 0.001), significant functional mitral regurgitation was detected in 30.3% vs 23.1% (p < 0.001), LV filling pressure was high in 27.2% vs 13.8% (p < 0.001), SPAP was 42.03 ± 15.30 vs 37.27 ± 15.43 mmHg (p = 0.034). Betablockers were prescribed in 88% vs 86.3% (p = 0.092), Ivabradine in 2.4% vs 7.3% (p < 0.001), loop diuretics in 47.7% vs 43.4% (p < 0.001), Spirinolactone in 58.5% vs 55.5% (p < 0.001), ACE-I were prescribed in 83.3% vs 78% (p < 0.001) and ARB in 11% vs 22.5% (p < 0.001). HF hospitalization represented 23.8% vs 16% (p < 0.001) and global mortality accounted for 3.4% vs 1.7% (p < 0.001).

Conclusion: Our study shows the importance of RV systolic function evaluation for the risk stratification of patients. RV systolic dysfunction identifies patients at increased risk of hospitalization for heart failure and mortality.

 

Keywords: Right Ventricular Dysfunction; Heart Failure with Reduced Ejection Fraction; NYHA Functional Class; Hospitalization for Heart Failure; Mortality

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Citation: Hanane Mechal., et al. “Prognostic Impact of Right Ventricle Dysfunction and Associated Echocardiographic Data in Heart Failure Patients with Reduced Ejection Fraction”. EC Cardiology 9.1 (2022): 20-29.

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