Evaluation of right ventricular function by echocardiography, including speckle echocardiography, in patients with dilated cardiomyopathy
Chakrapani Seshachar, Greeshma Gopala ShaliniObjectives
Dilated cardiomyopathy (DCM) is a disorder with myocardial involvement invariably associated with left ventricular (LV) systolic dysfunction and progressive disorder chamber enlargement. Although LV assessment predominates in clinical evaluation, right ventricular (RV) function plays a crucial role in determining prognosis. This study of DCM uses advanced echocardiographic techniques. To characterize alterations in RV size and function in DCM and determine the prevalence of RV systolic dysfunction (RVSD) based on echocardiographic parameters.
Material and Methods
In this cross-sectional observational study, 40 patients with DCM (mean age: 53.3 ± 15.7 years; 72.5% male) underwent comprehensive 2D and speckle-tracking echocardiography. Parameters assessed included right atrial (RA) area, tricuspid annular plane systolic excursion (TAPSE), RV strain, fractional area change (FAC), myocardial performance index (MPI), RVS′, and RV length. Demographic, clinical, and electrocardiographic data were noted. RVSD was defined according to guideline-based echocardiographic cutoffs.
Results
RVSD was present in 26 of 40 patients (65%; 95% CI: 48.3–79.4%), while 14 patients (35%) had preserved RV function. Patients with RVSD exhibited significantly larger RA dimensions and reduced TAPSE, RV strain, FAC, and increased MPI (all p < 0.001). RVS′ ( p = 0.003) and RV length ( p = 0.02) also differed significantly between groups.
Conclusion
DCM has RV dysfunction in addition to LV dysfunction and is highly prevalent, and is associated with significant alterations in multiple echocardiographic indices. Given its prognostic importance, routine assessment of RV function, particularly by speckle-tracking echocardiography, should be integrated into the standard evaluation of patients with DCM.