Deterioration in right ventricular structure and function over time in patients with heart failure and preserved ejection fraction

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F19%3A00077682" target="_blank" >RIV/00023001:_____/19:00077682 - isvavai.cz</a>

Result on the web

<a href="https://academic.oup.com/eurheartj/article/40/8/689/5240922" target="_blank" >https://academic.oup.com/eurheartj/article/40/8/689/5240922</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/eurheartj/ehy809" target="_blank" >10.1093/eurheartj/ehy809</a>

Result language

angličtina

Original language name

Deterioration in right ventricular structure and function over time in patients with heart failure and preserved ejection fraction

Original language description

Aims Prevalent right ventricular (RV) dysfunction (RVD) is associated with increased mortality in patients with heart failure with preserved ejection fraction (HFpEF), but no study has characterized long-term changes in RV structure and function within the same patient. Methods and results Patients with unequivocal HFpEF defined by either invasive haemodynamics or hospitalization for pulmonary oedema (n = 271) underwent serial echocardiographic evaluations &gt;6 months apart. Clinical, structural, functional, and haemodynamic characteristics were examined. Over a median of 4.0 years (interquartile range 2.1-6.1), there was a 10% decline in RV fractional area change and 21% increase in RV diastolic area (both P &lt; 0.0001). These changes greatly exceeded corresponding changes in the left ventricle. The prevalence of tricuspid regurgitation increased by 45%. Of 238 patients with normal RV function at Exam 1, 55 (23%) developed RVD during follow-up. Development of RVD was associated with both prevalent and incident atrial fibrillation (AF), higher body weight, coronary disease, higher pulmonary artery and left ventricular filling pressures, and RV dilation. Patients with HFpEF developing incident RVD had nearly two-fold increased risk of death (adjusted hazard ratio 1.89, 95% confidence interval 1.01-3.44; P = 0.04). Conclusion While previous attention has centred on the left ventricle in HFpEF, these data show that right ventricular structure and function deteriorate to greater extent over time when compared with changes in the left ventricle. Further study is required to evaluate whether interventions targeting modifiable risk factors identified for incident RVD, including abnormal haemodynamics, AF, coronary disease, and obesity, can prevent RVD and thus improve outcomes.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

<a href="/en/project/NV17-28784A" target="_blank" >NV17-28784A: Mechanisms of right ventricular dysfunction in chronic heart failure</a><br>

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2019

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

European heart journal

ISSN

0195-668X

e-ISSN

—

Volume of the periodical

40

Issue of the periodical within the volume

8

Country of publishing house

GB - UNITED KINGDOM

Number of pages

11

Pages from-to

689-698

UT code for WoS article

000459343200013

EID of the result in the Scopus database

2-s2.0-85061958495