title: Right ventricular dysfunction in patients with idiopathic dilated cardiomyopathy: Prognostic value and predictive factors.
abstract: BACKGROUND
  Right ventricular (RV) dysfunction is an important predictor of impaired prognosis in idiopathic dilated cardiomyopathy.
  
  
  OBJECTIVE
  To determine the prognostic role of RV dysfunction, independent of left ventricular (LV) dysfunction.
  
  
  METHODS
  A total of 136 consecutive patients (73% men; mean age 59.0±13.2 years) with idiopathic dilated cardiomyopathy (LV ejection fraction ≤ 45%) were enrolled retrospectively. Thirty-four patients (25%, group 1) presented with RV dysfunction, defined as tricuspid annular plane systolic excursion (TAPSE) ≤ 15 mm; 102 patients (group 2) had preserved RV function.
  
  
  RESULTS
  Mean LV ejection fraction was 27.5±8.7%. Mean TAPSE was 18.6±5.4 mm (15-21.8 mm). Multivariable predictors of RV dysfunction were LV outflow tract time-velocity integral (odds ratio 0.8, 95% confidence interval [CI] 0.7-0.9; P=0.003) and E-wave deceleration time ≤ 145 ms (odds ratio 4.1, 95% CI 1.3-12.8; P=0.017). Major adverse cardiac event-free survival rates at 1 and 2 years were 64% and 55%, respectively, in group 1 and 87% and 79%, respectively, in group 2 (P=0.002). Both by multivariable analysis and after stratification using a propensity score, RV dysfunction emerged as an independent predictor for major adverse cardiac events (hazard ratio 3.2, 95% CI 1.3-7.6; P=0.009), along with right atrium area and age.
  
  
  CONCLUSIONS
  In idiopathic dilated cardiomyopathy, RV dysfunction with TAPSE ≤ 15 mm offers additional prognostic information, independent of the extent of LV dysfunction.
authors.affiliation: Department of Cardiology, institut lorrain du cœur et des vaisseaux, University Hospital of Nancy, Vandœuvre-lès-Nancy, France.
authors.forename: Clement
authors.initials: C
authors.lastname: Venner
authors.affiliation: Department of Cardiology, institut lorrain du cœur et des vaisseaux, University Hospital of Nancy, Vandœuvre-lès-Nancy, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Selton-Suty
authors.affiliation: Department of Cardiology, institut lorrain du cœur et des vaisseaux, University Hospital of Nancy, Vandœuvre-lès-Nancy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Huttin
authors.affiliation: Department of Clinical Epidemiology and Evaluation, S2R Centre, ESPRI, University Hospital of Nancy, Nancy, France.
authors.forename: Marie-Line
authors.initials: ML
authors.lastname: Erpelding
authors.affiliation: Department of Cardiology, institut lorrain du cœur et des vaisseaux, University Hospital of Nancy, Vandœuvre-lès-Nancy, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Aliot
authors.affiliation: Department of Cardiology, institut lorrain du cœur et des vaisseaux, University Hospital of Nancy, Vandœuvre-lès-Nancy, France. Electronic address: y.juilliere@chu-nancy.fr.
authors.forename: Yves
authors.initials: Y
authors.lastname: Juillière
mesh_terms: D002311:Cardiomyopathy, Dilated / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D018497:Ventricular Dysfunction, Right / Q000209:etiology* / Q000401:mortality*
keywords: Analyse de propensité; Cardiomyopathie dilatée; Dilated cardiomyopathy; Dysfonction ventriculaire droite; Heart failure; Insuffisance cardiaque; Propensity analysis; Right ventricular dysfunction