ASSESSMENT OF RV DYSFUNCTION AND LVEF IN HEART FAILURE PATIENTS USING SPECKLE TRACKING ECHOCARDIOGRAPHY

Background:RVdysfunction is well known prognostic marker of morbidity and mortality in all forms of heart failure independent of LVfunction. In this study we used newer modality of speckle tracking echocardiography to diagnose RV dysfunction and study its correlation with various categories of heart failure namely HFpef, HFmef and Hfref Aims: To study the correlation between RV dysfunction and LVEF Methods: In a single hospital based cross sectional study we studied 99 patients of clinical heart failure and classied them in 3 groups according to LVEF [ < 40%, 40-49% and > 50% ] and calculated RV dysfunction using STE on Philips cvx machine using dedicated Tomtec software for calculating RV strain. RV dysfunction was dened as RV free wall GLS < 19 and RV 6 segment GLS < 24. LVEF was calculated with modied Simpson method. NT ProBNP levels more than 150 pg/ml were considered abnormal. Patients with chronic obstructive pulmonary disease, organic valvular heart disease, rhythm other than sinus rhythm, history of pulmonary embolism, respiratory failure, congenital heart disease were excluded. Results:The mean (SD) of LVEF (%) in the RV Dysfunction group was 42.51 (12.04) and without RV Dysfunction group was 48.39 (9.67). 43.3% of the patients with RV Dysfunction had LVEF <40%. 26.9% of the patients with RV Dysfunction had LVEF: 40-49%. 29.9% of the patients with RV Dysfunction had LVEF: ≥50%. The difference was signicant between HFref and HFmef patients [p=0.01] and HFref and HFpef patients [p=0.04] but not between HFmef and HFpef patients. Conclusion:RVdysfunction signicantly increases in patients with LVEF < 40%