Relative Prognostic Importance of Left and Right Ventricular Ejection Fraction in Patients With Cardiac Diseases
Authors/Creators
- 1. Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Padua, Italy; Department of Echocardiography, Cardiac Division, Royal Brompton Hospital, London, United Kingdom.
- 2. Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Padua, Italy; Istituto Auxologico Italiano, IRCCS, and University of Milano-Bicocca, Milan, Italy.
- 3. Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Padua, Italy.
Description
Background: The study aimed (1) to assess the prognostic value of three-dimensional echocardiography (3DE) derived right ventricular (RV) ejection fraction (EF) and (2) to evaluate relative prognostic importance of reduced and preserved left ventricular (LV) EF and RVEF to predict all-cause mortality and cardiac death in a large cohort of patients with cardiac diseases.
Methods: LV and RV volumes and EF were assessed by 3DE in 394 patients with various cardiovascular diseases. Patients were divided into four groups: (1) normal LVEF (≥50%) and normal RVEF (≥45%), n = 183; (2) reduced LVEF (<50%) and normal RVEF (≥45%), n = 75; (3) normal LVEF (≥50%) and reduced RVEF (<45%), n = 61; (4) reduced LVEF (<50%) and reduced RVEF (<45%), n = 75. The patients were followed up for 3.7 ± 1.1 years.
Results: Reduced 3DE-derived RVEF was associated with all-cause mortality (P < .0001). The four groups had significantly different survival (P < .0001). Both all-cause mortality and cardiac death in patients with reduced RVEF and normal LVEF were significantly higher than in those with reduced LVEF and normal RVEF (P = .0007 and P = .0091, respectively) and did not differ significantly from patients with reduced EF of both ventricles (P = .2198 and P = .0846, respectively).
Conclusions: Reduced 3DE-derived RVEF was associated with all-cause mortality and cardiac death in patients with various cardiovascular diseases. Impairment of RVEF carried a significantly higher risk of mortality independent of LVEF.
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