title: Long-term prognostic value of longitudinal strain of right ventricle in patients with moderate heart failure.
abstract: BACKGROUND
  Right ventricular (RV) systolic dysfunction is a strong prognostic predictor in chronic heart failure (HF). However, assessment of RV function remains difficult. We investigated the prognostic value of different echocardiographic parameters for evaluating RV function in 60 patients with chronic HF and a low left ventricular ejection fraction (<40%) who were on optimal medical treatment.
  
  
  METHODS
  RV function was assessed using standard and tissue Doppler echocardiography. The following parameters were measured: tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC), right myocardial performance index (MPI), tissue Doppler peak myocardial velocity (Sm) and longitudinal strain of the right ventricular wall in the basal and middle segments.
  
  
  RESULTS
  During a mean follow-up of 32 ± 13 months, 6 patients died and 16 were hospitalised for HF. TAPSE, RVFAC, right MPI and Sm did not predict cardiovascular events. The only variable associated with either cardiac death or HF hospitalisation (p=0.002), or HF hospitalisation only (p<0.0001) was systolic longitudinal strain in the basal and middle segments of the RV wall.
  
  
  CONCLUSIONS
  Our study demonstrates that longitudinal RV strain is a powerful prognostic variable for the prediction of major cardiac events in patients with chronic HF.
authors.affiliation: Department of Applied and Experimental Medicine, Chair of Cardiology, University of Brescia, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizzardi
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Aloia
authors.forename: Giorgio
authors.initials: G
authors.lastname: Caretta
authors.forename: Tania
authors.initials: T
authors.lastname: Bordonali
authors.forename: Ivano
authors.initials: I
authors.lastname: Bonadei
authors.forename: Riccardo
authors.initials: R
authors.lastname: Rovetta
authors.forename: Filippo
authors.initials: F
authors.lastname: Quinzani
authors.forename: Silvia
authors.initials: S
authors.lastname: Bugatti
authors.forename: Antonio
authors.initials: A
authors.lastname: Curnis
authors.forename: Marco
authors.initials: M
authors.lastname: Metra
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002908:Chronic Disease; D015150:Echocardiography, Doppler / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007558:Italy / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016278:Ventricular Function, Right
chemical_list: D002317:Cardiovascular Agents