EDITORIAL

Prognostic importance of right ventricular dysfunction

R A Bleasdale, M P Frenneaux

Department of Cardiology, Wales Heart Research Institute, University of Wales College of Medicine, Cardiff, UK

Correspondence to:
Correspondence to:
Professor Michael P Frenneaux, Department of Cardiology, Wales Heart Research Institute, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, UK;
Frenneaux@cf.ac.uk

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Although left ventricular ejection fraction is a powerful predictor of mortality following a myocardial infarction, in certain situations right ventricular ejection fraction may provide additional prognostic information

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Keywords: right ventricle; heart failure, prognosis

Abbreviations: CHF, congestive heart failure; DCM, dilated cardiomyopathy; DVI, diastolic ventricular interaction; IHD, ischaemic heart disease; LVEDP, left ventricular end diastolic pressure; LVEF, left ventricular ejection fraction; RVEDP, right ventricular end diastolic pressure; RVEF, right ventricular ejection fraction; O₂; oxygen consumption

The first 150 words of the full text of this article appear below.

When considering the entire range of left ventricular ejection fractions (LVEF) after a myocardial infarction, this parameter is a powerful predictor of mortality.¹ However extended follow up studies have shown that prolonged survival occurs in some patients with congestive heart failure (CHF) who have adverse conventional prognostic markers, including very low LVEF.² In patients with LVEF < 20%, the absolute value has little prognostic significance but peak oxygen consumption (peak O₂) is predictive. There is increasing evidence that right ventricular ejection fraction (RVEF) is also a powerful predictor of mortality in this subgroup of patients—perhaps the most powerful predictor.

In patients with CHF caused by dilated cardiomyopathy (DCM), reduced RVEF assessed using gated heart pool scanning (< 38%) has been shown to be associated with increased mortality in patients with LVEF < 30% but not in those patients with higher LVEFs.¹ Similarly, in patients with ischaemic heart disease (IHD), . . . [Full text of this article]

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