Right heart dysfunction assessed with echography, B-type natriuretic peptide and cardiopulmonary test in patients with chronic heart failure

J Cardiovasc Med (Hagerstown). 2008 Jul;9(7):672-6. doi: 10.2459/JCM.0b013e3282f331eb.


Background: Right ventricle (RV) impairment could influence brain natriuretic peptide (BNP) circulating levels. It is not well known whether echocardiographic parameters assessing RV function could be related to BNP levels in patients with chronic heart failure (CHF). Controversial data are available about the role played by RV dysfunction in determining exercise capacity in CHF patients.

Methods: Sixty patients with CHF referred to our CHF Unit underwent blood sampling for BNP levels determination, cardiopulmonary exercise test with VO2 peak, VO2-AT and VE/VCO2 slope assessment and M-mode, two-dimensional and Doppler echocardiography with evaluation of right heart function [right atrial pressure (RAP), pulmonary artery pressure (PAP), severity of tricuspid regurgitation (TR), and tricuspid annular plane systolic excursion (TAPSE)].

Results: A significant correlation was detectable between BNP levels and TAPSE (r = -0.33; P < 0.05), RAP (r = 0.34; P < 0.05), PAP (r = 0.42; P < 0.05), TR (P for trend 0.05); correlation with TAPSE remained significant even in multivariate. VO2 peak was significantly related to RAP (r = -0.38, P < 0.05) and TR (P for trend 0.05); AT with PAP (r = -0.40, P < 0.05), RAP (r = -0.50, P < 0.05), TR (P for trend 0.05). Moreover, patients with TAPSE greater than 16 mm had higher values of VO2 peak (13.68 +/- 3.28 vs. 11.49 +/- 2.37 ml/kg/m', P < 0.05) and of VO2-AT (18.36 +/- 1.60 vs. 10.23 +/- 2.31 ml/kg/m'; P < 0.05).

Conclusion: Right heart dysfunction assessed by simple echocardiographic parameters is related to neurohormonal activation featured by increased BNP levels and to a worse functional capacity in CHF patients.

MeSH terms

  • Aged
  • Blood Pressure / physiology
  • Exercise Test*
  • Female
  • Heart Failure / physiopathology*
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology
  • Humans
  • Male
  • Natriuretic Peptide, Brain / blood*
  • Oxygen Consumption / physiology
  • Severity of Illness Index
  • Systole / physiology
  • Tricuspid Valve Insufficiency / diagnostic imaging
  • Tricuspid Valve Insufficiency / physiopathology
  • Ultrasonography
  • Ventricular Dysfunction, Right / diagnosis*
  • Ventricular Dysfunction, Right / physiopathology*


  • Natriuretic Peptide, Brain