Prevalence and predictors of right ventricular dysfunction in patients with left ventricular systolic dysfunction: Insights from cardiac magnetic resonance

Abstract

Background: For more than 10 years cardiovascular magnetic resonance (CMR) has been applied as the diagnostic tool in themeasurement of left ventricular (LV) volumes, function, andmass .The superb accuracy and reproducibility of CMR is well established making it a gold standard modality. Right ventricular (RV) parameters have a promising prognosticator in cardiovascular mortality andmorbidity; nevertheless it has been less investigated as compared to LV. The purpose of this study was sought to assess the prevalence of RV dysfunction (defined as RVEF <40%) in LV dysfunction patients (determined by LVEF <40%) and its predictors. Methods: A total of 280 patients with LV dysfunction referring for CMR were consecutively enrolled (66.1% male, mean age 65.3+12.5 years). Assessment for RV end-diastolic volume, end-systolic volume, myocardial mass, and RV ejection fractionwere performed. The predictors for impaired RV systolic function were then analysed. Results:Mean LVEF was 25.9 + 8.5%. RV dysfunction was found in 125 patients (44.6%). Using univariate analysis, age, New York Heart functional class, LVEF, LVEDV, LVESV and late gadolinium enhancement were significant predictors for RV dysfunction. By multivariate analysis, only age, New York Heart functional class and LVEF remained significant (p 0.03, p 0.02 and p 0.001, respectively). Conclusions: The prevalence of RV dysfunction in the patients with LV systolic dysfunction was as high as 44.6%. Age, New York Heart functional class and LVEF were the independent predictors of RV dysfunction. Prognostic value of RV dysfunction in patients with cardiomyopathies warrant further studies.