Right Ventricular Longitudinal Strain Measures Independently Predict Chronic Heart Failure Mortality

Echocardiography. 2016 Jul;33(7):992-1000. doi: 10.1111/echo.13199. Epub 2016 Feb 11.

Abstract

The assessment of right ventricular (RV) function still remains a challenge. Two-dimensional (2D) speckle tracking has recently been proposed to evaluate right ventricular function by analyzing myocardial deformation. The aim of this study was to evaluate the role of 2D systolic strain measures of RV in predicting mortality in patients with chronic heart failure (HF). We enrolled 332 outpatients in a stable clinical condition and in conventional therapy. A right ventricular-focused four-chamber view was analyzed by 2D speckle tracking to evaluate the global longitudinal strain of RV (RV-GLS) and the strain of RV free wall (RV-fwLS). During a mean follow-up of 36 ± 26 months, 64 patients died. Both RV-GLS and RV-fwLS were associated with all-cause mortality in univariate (HR: 1.16; 95% CI: 1.10-1.23; P < 0.001; C-index: 0.72; and HR: 1.10; 95% CI: 1.06-1.15; P < 0.001; C-index: 0.68, respectively) as well as multivariate analysis (HR: 1.13; 95% CI: 1.05-1.21; P:0.001; C-index: 0.85; and HR: 1.07; 95% CI: 1.02-1.12; P:0.004; C-index: 0.84, respectively). In conclusion, our findings demonstrate the role of RV 2D strain measures to independently predict mortality. These data highlight the clinical usefulness of this echocardiographic approach in the daily management of HF outpatients.

Keywords: echocardiography; heart failure; myocardial strain; right ventricular function.

MeSH terms

  • Causality
  • Chronic Disease
  • Comorbidity
  • Echocardiography / methods
  • Echocardiography / statistics & numerical data
  • Elasticity Imaging Techniques / methods
  • Elasticity Imaging Techniques / statistics & numerical data
  • Female
  • Heart Failure / diagnostic imaging*
  • Heart Failure / mortality*
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity
  • Stroke Volume*
  • Survival Analysis*
  • Ventricular Dysfunction, Right / diagnostic imaging*
  • Ventricular Dysfunction, Right / mortality*