Predictors of Right Ventricular Systolic Dysfunction in Non-Ischemic Dilated Cardiomyopathy: An Echocardiographic Study

Abstract

A B S T R A C TBackground: Right Ventricular (RV) functions are known to have an impact on determining the prognosis of patients with Non-Ischemic Dilated Cardiomyopathy (NICMP). Objectives: This study aimed to investigate the echocardiographic determinants of RV systolic dysfunction in patients with NICMP. Patients and Methods: This cross-sectional study was conducted on 79 patients with angiographically normal coronary arteries (mean age: 50.5 ± 12, mean Ejection Fraction (EF): 31 ± 4%) selected through purposive sampling The patients were divided into two groups based on their RV systolic function determined by tissue Doppler systolic velocities (RV-Sm): group A (RV-Sm ≥ 10 cm/s, N = 48) and group B (RV-Sm < 10 cm/s, N = 31). The two groups were compared regarding clinical, demographic, and echocardiographic variables using independent t-test and chi-square test. Results: The patients with RV systolic dysfunction were found to have higher Brain Natriuretic Peptide (BNP) values (P = 0.006) and worse functional status (New York Heart Association (NYHA) III-IV, P = 0.04) compared to group A. Besides, univariate analysis of the echocardiographic parameters revealed that the patients in group B had significantly (all P values < 0.05) higher Left Atrial Volume Index (LAVI), higher degree of left ventricular diastolic dysfunction (represented by LV-E/Em), higher degree of Functional Mitral Regurgitation (FMR), higher estimated Pulmonary Artery Systolic Pressure (PASP), and higher degree of RV diastolic dysfunction (represented by RV-E/ Em) Moreover, multivariate logistic regression analysis showed that severe FMR (P = 0.006) and RV-E/Em (P = 0.016) predicted RV systolic dysfunction independently. Conclusions: Advanced FMR and worse RV diastolic functions emerged as the independent predictors of RV systolic dysfunction in NICMP correlating to functional status and BNP levels.

The effect of kidney transplantation on speckled tracking echocardiography findings in patients on hemodialysis

“…Speckle tracking echocardiography (STE) is a method for early LV function change assessment and could be used for longitudinal LV function impairment when circumferential LV shortening remains preserved in the early phase of cardiac damage by diseases. 12 - 15 It is based on speckle (Speckles are spots that appear by the interaction of the ultrasound beam on the myocardial fiber) displacement analysis and is non-Doppler and non-angle dependent. 16 STE application in the cardiac evaluation included hypertension-related concentric changes, subclinical LV function impairment in diabetes and coronary artery disease, cardiomyopathies (including uremic cardiomyopathy), 17 valvular heart disease, heart failure evaluation, mechanical dyssynchrony and heart transplantation.…”