Kanagala, Prathap 
ORCID: 0000-0001-6739-5607, Arnold, Jayanth R, Singh, Anvesha, Khan, Jamal N, Gulsin, Gaurav S, Gupta, Pankaj, Squire, Iain B, Ng, Leong L and McCann, Gerry P
(2021)
Prevalence of right ventricular dysfunction and prognostic significance in heart failure with preserved ejection fraction.
INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, 37 (1).
pp. 255-266.
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Abstract
There is a paucity of data characterizing right ventricular performance in heart failure with preserved ejection fraction (HFpEF) using the gold standard of cardiovascular magnetic resonance imaging (CMR). We aimed to assess the proportion of right ventricular systolic dysfunction (RVD) in HFpEF and the relation to clinical outcomes. As part of a single-centre, prospective, observational study, 183 subjects (135 HFpEF, and 48 age- and sex-matched controls) underwent extensive characterization with CMR. transthoracic echocardiography, blood sampling and six-minute walk testing. Patients were followed for the composite endpoint of death or HF hospitalization. RVD (defined as right ventricular ejection fraction < 47%) controls was present in 19% of HFpEF. Patients with RVD presented more frequently with lower systolic blood pressure, atrial fibrillation, radiographic evidence of pulmonary congestion and raised cardiothoracic ratio and larger right ventricular volumes. During median follow-up of 1429 days, 47% (n = 64) of HFpEF subjects experienced the composite endpoint of death (n = 22) or HF hospitalization (n = 42). RVD was associated with an increased risk of composite events (Log-Rank p = 0.001). In multivariable Cox regression analysis, RVD was an independent predictor of adverse outcomes (adjusted Hazard Ratio [HR] 3.946, 95% CI 1.878-8.290, p = 0.0001) along with indexed extracellular volume (HR 1.742, CI 1.176-2.579, p = 0.006) and E/E' (HR 1.745, CI 1.230-2.477, p = 0.002). RVD as assessed by CMR is prevalent in nearly one-fifth of HFpEF patients and is independently associated with death and/or hospitalization with HF.The trial was registered retrospectively on ClinicalTrials.gov (Identifier: NCT03050593). The date of registration was February 06, 2017.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Heart failure with preserved ejection fraction, Right ventricular dysfunction, Prevalence, Prognosis, Cardiovascular magnetic resonance imaging |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Clinical Directorate |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 16 Mar 2021 09:23 |
| Last Modified: | 18 Jan 2023 22:56 |
| DOI: | 10.1007/s10554-020-01953-y |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3117358 |
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