Assessment of right ventricular function before and after decongestive theraphy
N Kahya ErenAbstract
Purpose
Right ventricular (RV) failure frequently co exist with left heart failure (HF) and it is associated with poor prognosis (1). Precise determination of RV function is crucial to guide clinical management. However, accurate assessment of RV function is challenging due to its’ complex shape, retrosternal position and load dependendy of the most of the echocardiographic indices used to determine RV function in clinical daily practice. In acute heart failure patients hemodynamic load of RV increases which may alter the values of most of the echocardiographic indices. Therefore it’s even more challanging for clinicians to evaluate right heart functions in this setting. In this study we aimed to investigate the changes in echocardiographic parameters that are used to evaluate RV fuction before and after decongestive theraphy
Methods
Patients hospitalised with acute heart failure due to reduced EF were enroled in the study. Right ventricular functions were evaluated by transthoracic echocardiography performed within the first 12 hours after hosptalisation and before discharge when congestive symptoms have resolved. Parameters of interest in this study were RV and right atrial lineer dimensions, TAPSE, fractional area change (FAC) of RV, peak tissue Doppler systolic RV velocities (RV S’) at the tricuspid annulus level by 2-D echocardiography, TAPSE/sPAP ratio; and RV volumes and EF evaluated by 3-D echocardiography.
Results
A total of 51 patients hospitalised with acute heart failure were included in the study. Demographic and clinical characteristics of the study population are presented in table 1. Echocardiographic parameters are shown in Table 2. Right ventricular lineer and volumetric dimensions decreased significantly after decongestive theraphy while there were no significant differences in terms of RV EF, TAPSE, RV S’and RV FAC.
Conclusion
Acute heart failure imposes a significant load on RV. Right ventricular dimensions significantly increased during an acute heart failure episode. However, indices that are related to function did not change sifnificantly.Table 1For image description, please refer to the figure legend and surrounding text.Table 2For image description, please refer to the figure legend and surrounding text.