Abstract
BackgroundDilated cardiomyopathy and ischaemic heart disease can both lead to right ventricular (RV) dysfunction. Direct comparisons of the two entities regarding RV size and function using state-of-the-art imaging techniques have not yet been performed. We aimed to determine RV function and volume in dilated cardiomyopathy and ischaemic heart disease in relation to left ventricular (LV) systolic and diastolic function and systolic pulmonary artery pressure.Methods and resultsA well-characterised group (cardiac magnetic resonance imaging, echocardiography, coronary angiography and endomyocardial biopsy) of 46 patients with dilated cardiomyopathy was compared with LV ejection fraction (EF)-matched patients (n = 23) with ischaemic heart disease. Volumes and EF were determined with magnetic resonance imaging, diastolic LV function and pulmonary artery pressure with echocardiography.After multivariable linear regression, four factors independently influenced RVEF (R2 = 0.51, p < 0.001): LVEF (r = 0.54, p < 0.001), ratio of peak early and peak atrial transmitral Doppler flow velocity as measure of LV filling pressure (r = − 0.52, p < 0.001) and tricuspid regurgitation flow velocity as measure of pulmonary artery pressure (r = − 0.38, p = 0.001). RVEF was significantly worse in patients with dilated cardiomyopathy compared with ischaemic heart disease: median 48 % (interquartile range (IQR) 37–55 %) versus 56 % (IQR 48–63 %), p < 0.05.ConclusionsIn patients with dilated cardiomyopathy and ischaemic heart disease, RV function is determined by LV systolic and diastolic function, the underlying cause of LV dysfunction, and pulmonary artery pressure. It was demonstrated that RV function is more impaired in dilated cardiomyopathy.
Highlights
Right ventricular (RV) dysfunction and dilatation are correlated to limited exercise capacity and poor outcome [1,2,3,4], but often neglected in the clinical setting [5, 6]
The non-invasive imaging techniques cardiac magnetic resonance imaging (CMR) and echocardiography were applied in patients with Dilated cardiomyopathy (DCM) and ischaemic heart disease (IHD) without right ventricular (RV) free wall infarction, to evaluate
RV systolic function was influenced by different factors including the underlying disease process, i.e. the presence of DCM, systolic and diastolic function of the left ventricular (LV) and elevation of the pulmonary artery systolic pressure (PAP)
Summary
Right ventricular (RV) dysfunction and dilatation are correlated to limited exercise capacity and poor outcome [1,2,3,4], but often neglected in the clinical setting [5, 6]. Direct comparisons of the two entities with respect to RV size and function using state-of-the-art imaging techniques have not yet been performed. We determined RV function and volume in relation to left ventricular (LV) systolic and diastolic function, and pulmonary artery pressure in patients with DCM to assess the main mechanisms of RV dysfunction. We aimed to determine RV function and volume in dilated cardiomyopathy and ischaemic heart disease in relation to left ventricular (LV) systolic and diastolic function and systolic pulmonary artery pressure. Methods and results A well-characterised group (cardiac magnetic resonance imaging, echocardiography, coronary angiography and endomyocardial biopsy) of 46 patients with dilated cardiomyopathy was compared with LV ejection fraction (EF)-matched patients (n = 23) with ischaemic heart disease.
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