title: Determinants of right ventricular failure in patients admitted with acute left heart failure.
abstract: Pulmonary hypertension, which may lead to right ventricular (RV) failure, increases with left ventricular (LV) diastolic dysfunction severity. The prevalence and determinants of RV failure were analyzed in 120 patients admitted with acute left heart (LH) failure. Patients were divided into RV failure (n=50) and non-RV failure (n=70) groups. The prevalence of RV failure was found to be 42%. In both groups, two thirds of the patients had isolated LV diastolic dysfunction and the rest had combined LV systolic and diastolic dysfunction. Patients in the RV failure group were characterized by higher LV diastolic grade (2.2 ± 0.6 vs 1.84 ± 0.7; P=.0070), pulmonary artery systolic pressure (PASP; 57.8 ± 15.3 vs 50.14 ± 12.1 mm Hg; P=.0028), right atrial enlargement (92% vs 25.7%; P=.000001), and more-than-moderate tricuspid regurgitation (58% vs 27.1%; P=.0006). RV failure is a frequent finding in patients with advanced LH failure. It is strongly associated with the severity of LV diastolic dysfunction and the severity of PASP.
authors.affiliation: Heart Failure and Pulmonary Hypertension Program, Hackensack Heart and Vascular Institute, Hackensack University Medical Center, Hackensack, NJ 07601, USA. rberkowitz@humed.com
authors.forename: Robert
authors.initials: R
authors.lastname: Berkowitz
authors.forename: Eyad
authors.initials: E
authors.lastname: Alhaj
authors.forename: Rama Bindu
authors.initials: RB
authors.lastname: Manchikalapudi
authors.forename: Kumar
authors.initials: K
authors.lastname: Satya
authors.forename: Sina
authors.initials: S
authors.lastname: Dadfarmay
authors.forename: Ramzan
authors.initials: R
authors.lastname: Zakir
mesh_terms: D000208:Acute Disease; D000368:Aged; D018450:Disease Progression; D004452:Echocardiography; D015981:Epidemiologic Factors; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D017380:Hypertrophy, Right Ventricular / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D015995:Prevalence; D011379:Prognosis; D011651:Pulmonary Artery / Q000473:pathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013223:Statistics as Topic; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology