Associations Between Echocardiographic Right Heart Measurements With Short‐Term Prognosis in Heart Failure: A Prospective Study

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 41; no. 10; pp. e15959 - n/a
• Main Authors: Dinç Asarcıklı, Lale, İnan, Duygu, Murat, Selda, Çöllüoğlu, İnci Tuğçe, Bakhshaliyev, Nijat, Ulutaş, Zeynep, Çabuk, Gizem, Hasırcı, Senem, Naser, Abdulrahman, Ünal Dayı, Şennur, Çelik, Ahmet, Güvenç, Tolga Sinan
• Format: Journal Article
• Language: English
• Published: United States 01-10-2024
• Subjects: Aged; echocardiography; Echocardiography - methods; Female; Follow-Up Studies; heart failure; Heart Failure - diagnostic imaging; Heart Failure - physiopathology; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Male; Middle Aged; Prognosis; Prospective Studies; right ventricle; Ventricular Dysfunction, Right - diagnostic imaging; Ventricular Dysfunction, Right - physiopathology; Ventricular Function, Right - physiology; right ventricle; heart failure; echocardiography
• ISSN: 0742-2822; 1540-8175; 1540-8175
• DOI: 10.1111/echo.15959

ABSTRACT
Background
Echocardiographic right ventricular (RV) dysfunction is a strong risk determinant for prognosis in patients with heart failure (HF). Although parameters of RV systolic function are widely used to define RV dysfunction, there is scarce data to suggest these parameters are best suited to predict HF‐related outcomes.
Aims
We aimed to understand which morphologic or functional parameters are most closely associated with short‐term mortality and HF‐related hospitalization in patients with HF.
Methods
A total of 191 patients from eight study centers were included to this study. A detailed echocardiographic examination was done at enrollment, and patients were followed up for 6 months via direct interviews or phone calls.
Results
All right‐sided echocardiographic parameters other than tricuspid annular plane systolic excursion were associated with outcomes. In a proportional hazards model that included right‐heart parameters, RV longitudinal diameter (HR: 1.07, 95%CI: 1.04–1.10, p < 0.001), wall thickness (HR: 1.3, 95%CI: 1.13–1.50, p < 0.001), and tricuspid annular systolic velocity (HR: 0.90, 95%CI: 0.82–0.96, p = 0.02) were found as the independent predictors. However, only RV longitudinal dimension (HR: 1.04, 95%CI: 1.01–1.08, p = 0.01) and RV wall thickness (HR: 1.32, 95%CI: 1.10–1.60, p = 0.004) were associated with short‐term outcomes after adjusting for other clinical and left‐sided echocardiographic variables. On a Bayesian logistic regression model that included right‐sided echocardiography variables, there was strong evidence for including either RV longitudinal diameter (BF10: 190.4) or wall thickness (BF10: 30.7) to the final model.
Conclusion
Parameters of RV morphology were better predictors of short‐term outcomes in HF patients.
This study illustrates that morphological measurements of the right ventricle, particularly longitudinal diameter and wall thickness, are more closely associated with short‐term prognosis in patients with heart failure compared to functional measurements such as tricuspid annular systolic excursion or fractional area change.