The relation between the etiology of cardiomyopathy and the function of the right
ventricle (RV) has not been well described in the current era of 3-dimensional cardiac
imaging. New advances in cardiac imaging with computed tomography (CT) have allowed
accurate measurements of ejection fraction (EF), often a challenging task considering
the unique RV shape. We evaluated 130 patients at the Loma Linda Veterans Affairs
Healthcare System with cardiomyopathy and a left ventricular (LV) EF ≤40%. Etiology
of cardiomyopathy was determined by CT angiography as ischemic (n = 56) or nonischemic
(n = 74). RV volumes and RVEF were calculated based on 3-dimensional data set from
CT images. Baseline LVEF was similar with a mean LVEF of 28% (±6%) in the ischemic
group and 28% (±9%) in the nonischemic group (p = 0.46). RV function and volumes were
moderately decreased in both cohorts, without significant difference between the groups
(mean RVEF 34 ± 11% in ischemic group and 32 ± 10% in nonischemic group, p = 0.26).
In conclusion, most patients with LV dysfunction also have RV dysfunction. The degree
of RV dysfunction is not dependent on the etiology of cardiomyopathy.
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References
- Executive summary: heart disease and stroke statistics–2013 update: a report from the American Heart Association.Circulation. 2013; 127: 143-152
- Survival trends in men and women with heart failure of ischaemic and non-ischaemic origin: data for the period 1987-2003 from the Swedish Hospital Discharge Registry.Eur Heart J. 2009; 30: 671-678
- Report of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies.Circulation. 1996; 93: 841-842
- A standardized definition of ischemic cardiomyopathy for use in clinical research.J Am Coll Cardiol. 2002; 39: 210-218
- Clinical determinants of mortality in patients with angiographically diagnosed ischemic or nonischemic cardiomyopathy.J Am Coll Cardiol. 1997; 30: 1002-1008
- Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure.Circulation. 2010; 121: 252-258
- Effect of right ventricular function and pulmonary pressures on heart failure prognosis.Prev Cardiol. 2010; 13: 72-77
- Left ventricular versus biventricular dysfunction in idiopathic dilated cardiomyopathy.Am J Cardiol. 1999; 83: 120-122
- Reduced right ventricular ejection fraction as a marker for idiopathic dilated cardiomyopathy compared with ischemic left ventricular dysfunction.Am Heart J. 2001; 142: 181-189
- Comparison of right ventricular systolic function in idiopathic dilated cardiomyopathy and healed anterior wall myocardial infarction associated with atherosclerotic coronary artery disease.Am J Cardiol. 1994; 73: 588-590
- Right ventricular function in cardiovascular disease, Part I: anatomy, physiology, aging, and functional assessment of the right ventricle.Circulation. 2008; 117: 1436-1448
- Evaluation of the right ventricle by magnetic resonance imaging.Am Heart J. 1987; 113: 8-15
- Reproducibility of MRI-derived measurements of right ventricular volumes and myocardial mass.Magn Reson Imaging. 1995; 13: 53-63
- Assessment of right ventricular diastolic and systolic function in patients with dilated cardiomyopathy using cine magnetic resonance imaging.Am Heart J. 1991; 122: 1035-1040
- Accuracy of cardiac CT, radionucleotide and invasive ventriculography, two- and three-dimensional echocardiography, and SPECT for left and right ventricular ejection fraction compared with cardiac MRI: a meta-analysis.Eur Heart J Cardiovasc Imaging. 2015; 16: 848-852
- Left and right ventricle assessment with cardiac CT: validation study vs. cardiac MR.Eur Radiol. 2012; 22: 1041-1049
- Right ventricle function assessment by MDCT.AJR Am J Roentgenol. 2011; 196: 77-86
- Assessment of global right ventricular function on 64-MDCT compared with MRI.AJR Am J Roentgenol. 2008; 190: 1358-1361
- Assessment of right ventricular function by 16-detector-row CT: comparison with magnetic resonance imaging.Eur Radiol. 2005; 15: 312-318
- Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure.Circulation. 2008; 117: 1717-1731
- Additional predictive value of both left and right ventricular ejection fractions on long-term survival in idiopathic dilated cardiomyopathy.Eur Heart J. 1997; 18: 276-280
- Comparison of right versus left ventricular strain analysis as a predictor of outcome in patients with systolic heart failure referred for heart transplantation.Am J Cardiol. 2013; 112: 1778-1784
- Right ventricular function and failure: report of a National Heart, Lung, and Blood Institute working group on cellular and molecular mechanisms of right heart failure.Circulation. 2006; 114: 1883-1891
- Pathophysiology and management of right heart ischemia.J Am Coll Cardiol. 2002; 40: 841-853
- Right ventricular infarction.N Engl J Med. 1994; 330: 1211-1217
- Patterns of coronary compromise resulting in acute right ventricular ischemic dysfunction.Circulation. 2002; 106: 1104-1109
- Pathophysiology of cor pulmonale in chronic obstructive pulmonary disease.Am J Respir Crit Care Med. 1994; 150: 833-852
- Physiologic correlates of right ventricular ejection fraction in chronic obstructive pulmonary disease: a combined radionuclide and hemodynamic study.Am J Cardiol. 1982; 50: 255-262
Article Info
Publication History
Published online: November 05, 2015
Accepted:
October 14,
2015
Received in revised form:
October 14,
2015
Received:
July 22,
2015
Footnotes
The authors of the article were solely responsible for the preparation, composition, and submission of this study.
See page 280 for disclosure information.
Identification
Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
