0065 : Right ventricular systolic function in heart failure, a Moroccan experience

Abstract

The right ventricle (RV) has received less attention than the left in heart failure patients probably because morbidity and mortality associated with left ventricular disease is clinically more apparent. In our study, we tried to prove the importance to characterize the prevalence and clinical significance of right ventricular (RV) systolic dysfunction (RVD) in patients with heart failure. We studied 1613 patients with chronic heart failure at the HF Registry of the university hospital Ibn Rochd Casablanca, during a follow up of 6 years. RVF (RV function) were determined by echocardiography, RV dysfunction defined by (S’VD <10cm / s and TAPSE <16mm). The primary endpoint was the occurrence of acute heart failure decompensation (AHFD). RESULTS: RVD was present in 117 patient (7.17%), this group had an average age of 64 years, they were more likely to be men (sex ratio: 2,1), to have atrial fibrillation, and chronic diuretic therapy. At echo, patients with RVD had slightly lower LVEF (75% lower LVEF and 25% preserved LVEF), worse diastolic dysfunction, lower blood pressure and cardiac output, higher pulmonary artery systolic pressure (PASP) 23%, and more severe RV enlargement and tricuspid valve regurgitation. Patients with RV dysfunction had 11.54% of AHFD occurrence. The association of both RVD and pulmonary hypertension increased the risk of AHFD (14.28%), while patients with normal RVF had only 1.48% to develop AHFD. Adjusting for age, sex, PASP and comorbidities, RVD defined by TAPSE and echo Doppler tissue imaging, was associated with higher risk of HF decompensation. In our community, RVD is common in HF patients, associated with clinical and echocardiographic evidence of more advanced HF and predictive of poorer outcomes so it had independent prognostic utility. We should give more attention to the RVF in our systematic assessment of HF patients.