TY - JOUR
T1 - Right ventricular dysfunction as an independent predictor of short- and long-term mortality in patients with heart failure
AU - Kjaergaard, Jesper
AU - Akkan, Dilek
AU - Iversen, Kasper Karmark
AU - Køber, Lars
AU - Torp-Pedersen, Christian
AU - Hassager, Christian
N1 - Keywords: Adrenergic alpha-Agonists; Aged; Aged, 80 and over; Cardiotonic Agents; Comorbidity; Dopamine Agonists; Echocardiography; Esters; Female; Follow-Up Studies; Heart Failure; Humans; Male; Myocardial Contraction; Prognosis; Proportional Hazards Models; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Risk Factors; Stroke Volume; Survival Analysis; Tetrahydronaphthalenes; Tricuspid Valve; Ventricular Dysfunction, Right
PY - 2007
Y1 - 2007
N2 - BACKGROUND: The prognostic importance of right ventricular (RV) dysfunction in heart failure (HF) has been suggested in patients with severe systolic heart failure. Tricuspid annular plane systolic excursion (TAPSE) is a simple echocardiographic measure of RV ejection fraction, but may be affected by co-existing chronic obstructive pulmonary disease (COPD). AIMS: To examine the prognostic information from TAPSE adjusted for the potential confounding effects of co-existing cardiovascular and COPD in a large series of patients admitted for new onset or worsening HF. METHODS AND RESULTS: Eight hundred and seventeen patients screened for participation in a large clinical trial by trans-thoracic echocardiography, including measurement of TAPSE, were followed for a median of 4.1 years (maximum 5.5 years). Decreased TAPSE as well as presence of COPD were independently associated with adverse short- and long-term survival, hazard ratio was 0.74 (p=0.004) for every doubling of TAPSE; and 2.4 (p<0.0001) for the presence of COPD. CONCLUSION: Decreased RV systolic function as estimated by TAPSE is associated with increased mortality in patients admitted for HF, and is independent of other risk factors in HF including left ventricular function. The co-existence of COPD is also associated with an adverse prognosis independent of the RV systolic function.
AB - BACKGROUND: The prognostic importance of right ventricular (RV) dysfunction in heart failure (HF) has been suggested in patients with severe systolic heart failure. Tricuspid annular plane systolic excursion (TAPSE) is a simple echocardiographic measure of RV ejection fraction, but may be affected by co-existing chronic obstructive pulmonary disease (COPD). AIMS: To examine the prognostic information from TAPSE adjusted for the potential confounding effects of co-existing cardiovascular and COPD in a large series of patients admitted for new onset or worsening HF. METHODS AND RESULTS: Eight hundred and seventeen patients screened for participation in a large clinical trial by trans-thoracic echocardiography, including measurement of TAPSE, were followed for a median of 4.1 years (maximum 5.5 years). Decreased TAPSE as well as presence of COPD were independently associated with adverse short- and long-term survival, hazard ratio was 0.74 (p=0.004) for every doubling of TAPSE; and 2.4 (p<0.0001) for the presence of COPD. CONCLUSION: Decreased RV systolic function as estimated by TAPSE is associated with increased mortality in patients admitted for HF, and is independent of other risk factors in HF including left ventricular function. The co-existence of COPD is also associated with an adverse prognosis independent of the RV systolic function.
U2 - 10.1016/j.ejheart.2007.03.001
DO - 10.1016/j.ejheart.2007.03.001
M3 - Journal article
C2 - 17462946
SN - 1388-9842
VL - 9
SP - 610
EP - 616
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 6-7
ER -