The dynamic assessment of right-ventricular function and its relation to exercise capacity in heart failure.
OBJECTIVE
To evaluate right-ventricular (RV) function during stress echocardiography (SE) and to assess its relationship with exercise capacity in heart failure (HF) patients.


RESULTS
We included 88 patients aged 60.9 +/- 11.2 years with a mean LVEF of 27.2 +/- 9.5%. The following RV parameters were measured at baseline and peak exercise during semi-supine SE: velocity (IVV) and acceleration during isovolumic contraction (IVA), S', E', A', and ratio of early diastolic tricuspid velocity to E' (E/E') and longitudinal strain and strain rate. Patients were stratified into two groups according to their VO(2peak) values: group 1 (n = 35) with VO(2peak) <14 mL/kg/min and group 2 (n = 53) with VO(2peak) >or=14 mL/kg/min. At rest, all analysed variables were similar in the two groups, but during stress IVV, S', and E' were significantly higher and the E/E' ratio significantly lower in group 2. In broad terms, parameters measured at stress correlated much better with VO(2peak) than parameters assessed at baseline. However, results of multivariable analysis determined that the independent predictors of VO(2peak) were solely the left-ventricular (LV) parameters: E/E' and S'.


CONCLUSIONS
Right-ventricular function (whether at rest or during stress tests) was not significantly associated with exercise capacity in our patients with HF. In contrast, systolic and, to a greater extent, diastolic LV parameters during the stress tests emerged as the most important indicators linked to exercise capacity in HF.
Rubis
Pawel
P
Department of Cardiac and Vascular Disease in John Paul II Hospital, Institute of Cardiology, Faculty of Medicine, Jagiellonian University, Krakow, Poland. rubispp@gmail.com
Podolec
Piotr
P
Kopec
Grzegorz
G
Olszowska
Maria
M
Tracz
Wieslawa
W
D002302:Cardiac Output; D002311:Cardiomyopathy, Dilated / Q000150:complications; D003971:Diastole; D025401:Echocardiography, Stress; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000150:complications; D010101:Oxygen Consumption; D013223:Statistics as Topic; D014261:Tricuspid Valve; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right