title: Role of right ventricular systolic function on long-term outcome in patients with newly diagnosed systolic heart failure.
abstract: BACKGROUND
  Right ventricular (RV) systolic function has been recognized as a prognostic factor in endstage heart failure (HF) patients and in the present study we evaluated the effect of this dysfunction on prognosis in patients with newly-diagnosed systolic HF.
  
  
  RESULTS
  We enrolled 180 consecutive patients with newly diagnosed systolic HF (ischemic or dilated cardiomyopathy). Echocardiographic evaluation was performed to assess biventricular function. Pulse-wave tissue Doppler imaging (TDI) readings were obtained from the lateral tricuspid annulus and the peak systolic annular velocity (Stv) was recorded. Patients were followed for a 2-year period and events (death or HF hospitalization) were recorded. During the follow-up, 79 patients (44%) had an adverse event. An inverse relationship was observed between the height of Stv and the probability of an event (odds ratio (OR) 0.716, 95% confidence interval (CI) 0.583-0.880, P=0.001), after controlling for potential confounders. Furthermore, creatinine clearance (CrCl) was inversely associated with the outcome: a 1-unit increase in CrCl was associated with a 0.98-times lower likelihood of having an event. When the analysis was stratified by CrCl < 60 ml/min or ≥ 60 ml/min, Stv predicted adverse events in both groups (CrCl < 60 ml/min: OR 0.62, 95%CI 0.39-0.98, P = 0.04; CrCl ≥ 60 ml/min: OR 0.78, 95%CI 0.61-1.01, P=0.06).
  
  
  CONCLUSIONS
  Pulse-wave TDI readings of peak systolic velocity at the lateral tricuspid annulus, reflecting RV systolic function, has prognostic significance in newly-diagnosed systolic HF patients.
authors.affiliation: Heart Failure Unit, 1st Department of Cardiology, Hippokration General Hospital, School of Medicine, University of Athens, Athens, Greece. chrysohoou@usa.net
authors.forename: Christina
authors.initials: C
authors.lastname: Chrysohoou
authors.forename: Christos-Konstantinos
authors.initials: CK
authors.lastname: Antoniou
authors.forename: Iason
authors.initials: I
authors.lastname: Kotrogiannis
authors.forename: George
authors.initials: G
authors.lastname: Metallinos
authors.forename: Athanasios
authors.initials: A
authors.lastname: Aggelis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Andreou
authors.forename: Stella
authors.initials: S
authors.lastname: Brili
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D016278:Ventricular Function, Right