© 2005 European Society of Cardiology
Right ventricular dysfunction in chronic heart failure patients
pinarová*
í Toman
íí Vítovec
1st Cardio-angiologic Department, University Hospital Pekaská 53, 656 91 Brno, Czech Republic
* Corresponding author. Tel./Fax: +420 54318 2212. E-mail address: lenka.spinarova{at}fnusa.cz
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Abstract |
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Aim: To evaluate any differences in haemodynamic and echocardiographic parameters in patients with both left (LV) and right ventricular (RV) systolic dysfunction and in patients with isolated LV systolic dysfunction.
Study group: One hundred patients with RV systolic dysfunction defined as peak velocity of tricuspid annular motion in systole (Sa)<11.5 cm/s, and 55 patients without RV systolic dysfunction Sa>11.5 cm/s. All patients had LV systolic dysfunction, LV ejection fraction (EF) below 40%, NYHA II–IV.
Methods: LV diameters, volumes and EF were measured by echocardiography. Patients underwent tissue Doppler imaging (TDI) of tricuspid annular motion with measurement of peak systolic velocity (Sa), peak early (Ea) and peak late (Aa) diastolic velocities. Right heart catheterization was also performed.
Results: Patients with RV systolic dysfunction did not differ from those without RV systolic dysfunction in terms of LV function. Patients with RV systolic dysfunction had larger RV dimension 30.6±5.8 vs. 33.9±6.7 mm, p<0.002. The patients with RV systolic dysfunction had higher values on right heart catheterization: MPAP 29.6±12.1 vs. 24.9±11.4 mm Hg, p<0.02, PCWP 20.8±10.0 vs. 17.3±9.3 mm Hg, p<0.03, PVR 189.9±123.3 vs. 137.7±94.9 dyn s cm<5, p<0.008, CVP 7.7±5.6 vs. 5.1±3.9 mm Hg, p<0.002. The patients with RV systolic dysfunction had more pronounced diastolic dysfunction measured by TDI: Ea 9.9±2.3 vs. 11.4±2.5 cm/s, p<0.0001 and Aa 13.1±4.0 vs. 16.5±4.7 cm/s, p<0.000007.
Conclusion: Patients with heart failure and both left and right ventricular systolic dysfunction showed more serious findings on central haemodynamics as well as more pronounced right ventricular diastolic dysfunction than those with isolated left ventricular systolic dysfunction.
Key Words: Right ventricle • Doppler tissue imaging • Tricuspid annulus • Haemodynamics
Received October 8, 2003; Revised January 20, 2004; Accepted July 9, 2004
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