Right Ventricular Function Relates to Functional Capacity in Men with Atrial Fibrillation and Preserved Left Ventricular Ejection Fraction

Abstract

While left ventricular (LV) diastolic function (E/e') is related to functional capacity in patients with atrial fibrillation (AF), the underlying mechanism is unclear. Right ventricular (RV) function is related to prognosis in various diseases, however, its relationship with LV diastolic function is not well-studied. We sought to examine the reliability of echocardiographic indices of RV function in AF, the relationship between LV diastolic function and RV function, and the relationship between RV function and 6MWT distance in ambulatory patients with AF. We designed a retrospective study evaluating 52 veterans with AF and preserved LV ejection fraction (LVEF) who underwent echocardiography and 6MWT at scheduled visits throughout 1 year. We performed pairwise correlation to evaluate reproducibility of echocardiographic indices of RV function measured 1 week apart. Multiple regression was used to assess the association of indices of RV function to LV diastolic function and functional capacity. Most RV function indices had good to excellent correlation between 2 visits 1 week apart (coefficient 0.50-0.81) with test-retest variations of <6%, except for tricuspid annular plane systolic excursion (TAPSE), which had a significant variation in 9%. TAPSE, RV S' and RV e' were significantly related to LV diastolic function after adjusting for RV systolic pressure. After further adjustment for comorbidities, only RV S' and RV e' remained significantly related to 6MWT. RV tissue Doppler measurements (S' and e') had good reproducibility and were independently related to LV diastolic function and 6MWT in men with AF and preserved LVEF.