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Incremental Prognostic Value of Right Ventricular Strain in Patients With Acute Decompensated Heart Failure
- Source :
- Circulation. Cardiovascular imaging. 11(10)
- Publication Year :
- 2018
-
Abstract
- Background: Although 2-dimensional strain analyses based on speckle tracking echocardiography have been used to detect myocardial deformation, the prognostic impact of 2-dimensional strain is unclear in patients with acute decompensated heart failure (HF). We investigated whether left ventricular and right ventricular (RV) strain parameters assessed by speckle tracking echocardiography provide incremental prognostic information in hospitalized patients because of acute decompensated HF. Methods and Results: Six hundred eighteen patients (age, 72±13 years; 38% women; ejection fraction, 46±16%) hospitalized for acute decompensated HF underwent clinical and echocardiographic evaluation just before discharge. We performed strain analyses of left ventricular global longitudinal strain and left ventricular global circumferential strain. We also analyzed RV longitudinal strain only from the free wall (RV-fwLS) and from all segments of the RV global longitudinal strain wall by using Tomtec software. The primary composite end point was cardiovascular death and readmission for HF. There were 34.8% cardiac events during a median follow-up of 427 days. In multivariate Cox models, among echocardiographic parameters, only impaired RV-fwLS (≥−13.1%; hazard ratio, 1.51; 95% CI, 1.12–2.04; P =0.01) was independently associated with cardiac events. Adding RV-fwLS to clinical risk evaluation (age, New York Heart Association class III/IV, blood urea nitrogen, and brain natriuretic peptide) markedly improved prognostic utility and consequently increased net reclassification improvement by 0.30 ( P =0.01). Conclusions: RV-fwLS is an independent predictor of cardiac events in acute decompensated HF and provides greater prognostic power than standard echocardiographic parameters.
- Subjects :
- Male
medicine.medical_specialty
Time Factors
Acute decompensated heart failure
Heart Ventricles
Strain (injury)
Speckle tracking echocardiography
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Internal medicine
medicine
Humans
Radiology, Nuclear Medicine and imaging
In patient
030212 general & internal medicine
Aged
Retrospective Studies
Heart Failure
business.industry
Stroke Volume
medicine.disease
Prognosis
Echocardiography
Heart failure
Acute Disease
Cardiology
Disease Progression
Ventricular Function, Right
Female
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 19420080
- Volume :
- 11
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- Circulation. Cardiovascular imaging
- Accession number :
- edsair.doi.dedup.....10f86f8ca07387c88e074281e1580084