title: Long-term prognostic value of the right ventricular myocardial performance index compared to other indexes of right ventricular function in patients with moderate chronic heart failure.
abstract: BACKGROUND
  The ventricular myocardial performance index (MPI) is a feasible echocardiographic parameter for the evaluation of patients with chronic heart failure (CHF). The long-term prognostic role of right ventricular MPI (RV MPI) has been already assessed in patients with more advanced CHF but data are lacking in moderate CHF. The aim of the study is to evaluate the possible prognostic role of RV MPI in moderate CHF patients compared to others traditional RV parameters.
  
  
  METHODS
  From 2003 to 2004 we enrolled 95 consecutive NYHA class II CHF patients (65 males and 30 females), with the mean age of 66 ± 11 years with left ventricular ejection fraction (LVEF) <40%, on optimal medical treatment. All patients were evaluated clinically and by echocardiography with a follow-up of 5 years (combined end point: cardiovascular mortality and hospitalization for HF).
  
  
  RESULTS
  RV MPI was 0.45 ± 0.36, tricuspid annular plane systolic excursion was 21 ± 8 mm, RV fractional area change was 42 ± 12%, systolic pulmonary artery pressure was 33 ± 9 mmHg, and acceleration time of pulmonic flow was 115.5 + 22.62 msec. After the 5 year follow-up the total mortality was 24.2% and HF hospitalization rate was 33%. At Cox multivariate analysis only an RV MPI superior to median value (>0.38) and tricuspid annular plane systolic excursion inferior to median value (<18 mm) had shown a significant prognostic role.
  
  
  CONCLUSIONS
  The RV MPI in a population of moderate CHF showed to have a more long-term powerful prognostic value than other conventional and traditional echocardiographic right ventricular functional parameters.
authors.affiliation: Section of Cardiovascular Diseases, Department of Experimental and Applied Medicine, University of Study of Brescia, Brescia, Italy. enrico.vizzardi@tin.it
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizzardi
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Aloia
authors.forename: Tania
authors.initials: T
authors.lastname: Bordonali
authors.forename: Silvia
authors.initials: S
authors.lastname: Bugatti
authors.forename: Barbara
authors.initials: B
authors.lastname: Piovanelli
authors.forename: Ivano
authors.initials: I
authors.lastname: Bonadei
authors.forename: Filippo
authors.initials: F
authors.lastname: Quinzani
authors.forename: Riccardo
authors.initials: R
authors.lastname: Rovetta
authors.forename: Alberto
authors.initials: A
authors.lastname: Vaccari
authors.forename: Antonio
authors.initials: A
authors.lastname: Curnis
authors.forename: Livio
authors.initials: L
authors.lastname: Dei Cas
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D004453:Echoencephalography / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000401:mortality*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016019:Survival Analysis; D015996:Survival Rate; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000401:mortality*