The prognostic significance of right ventricular tissue Doppler parameters in patients with left ventricular systolic heart failure: an observational cohort study
- 1Department of Clinical Science and Education, South Hospital (Södersjukhuset), Karolinska Institute, Stockholm, Sweden
- 2Department of Cardiology, Danderyds Hospital, Karolinska Institute, Stockholm, Sweden
- Correspondence to Dr Jens Olson, Department of Clinical Science and Education, South Hospital (Södersjukhuset), Karolinska Institute, Sjukhusbacken 10, Stockholm 11883, Sweden;
Contributors JO has collected the data, made the statistical analysis and written the main part of the article. JO works as guarantor of the article. BS has contributed with valuable opinions on planning of the study and has taken active part in writing the article MA has done the main work of planning the study and has included most of the patients to the study. MA has had a major impact on the writing of the article.
- Accepted 22 May 2012
- Published Online First 19 June 2012
Objectives To investigate the value of tissue Doppler imaging (TDI) measurements of right ventricular (RV) systolic and diastolic function as a predictor of long term cardiovascular outcomes in patients with left ventricular (LV) systolic heart failure.
Background In patients with LV systolic heart failure, RV function has been shown to be an important predictor of outcome. TDI is probably a clinically useful method for assessing RV function. The studies published so far have had a rather short follow-up period and have excluded patients with atrial fibrillation.
Methods 156 patients admitted to the cardiology department due to decompensated heart failure were included in this observational cohort study. 19% had atrial fibrillation. An echocardiographic examination was performed at entry to the study. The patients were then followed for a mean of 829 days. The primary endpoint was cardiovascular mortality or hospitalisation for decompensated heart failure.
Results 43 patients (28%) died from cardiovascular causes and 55 patients (35%) patients were hospitalised. 80 patients (51%) reached the study endpoint. Only age and a combined systolic and diastolic TDI parameter (s'r + e'r < 18.5 cm/s) of the right ventricle were independent predictors of cardiovascular outcome (HR 1.99, p=0.007).
Conclusion A combined measure of RV systolic and diastolic function, using TDI, can be used as an independent predictor of outcome in patients with LV systolic heart failure.
Funding This study was partly supported by a grant of Stockholms läns landsting (ALF medicine).
Competing interests None.
Patient consent Obtained.
Ethics approval Regional Committee of Research Ethics, Stockholm.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The raw material, such as tissue Doppler imaging recordings, Excel and Predictive Analytics SoftWare (version 18.0) files are available on request by researchers, but will be changed before sharing to avoid identification of individual patients.