title: Right Ventricular Longitudinal Strain Measures Independently Predict Chronic Heart Failure Mortality.
abstract: The assessment of right ventricular (RV) function still remains a challenge. Two-dimensional (2D) speckle tracking has recently been proposed to evaluate right ventricular function by analyzing myocardial deformation. The aim of this study was to evaluate the role of 2D systolic strain measures of RV in predicting mortality in patients with chronic heart failure (HF). We enrolled 332 outpatients in a stable clinical condition and in conventional therapy. A right ventricular-focused four-chamber view was analyzed by 2D speckle tracking to evaluate the global longitudinal strain of RV (RV-GLS) and the strain of RV free wall (RV-fwLS). During a mean follow-up of 36 ± 26 months, 64 patients died. Both RV-GLS and RV-fwLS were associated with all-cause mortality in univariate (HR: 1.16; 95% CI: 1.10-1.23; P < 0.001; C-index: 0.72; and HR: 1.10; 95% CI: 1.06-1.15; P < 0.001; C-index: 0.68, respectively) as well as multivariate analysis (HR: 1.13; 95% CI: 1.05-1.21; P:0.001; C-index: 0.85; and HR: 1.07; 95% CI: 1.02-1.12; P:0.004; C-index: 0.84, respectively). In conclusion, our findings demonstrate the role of RV 2D strain measures to independently predict mortality. These data highlight the clinical usefulness of this echocardiographic approach in the daily management of HF outpatients.
authors: Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Bari, Italy.
authors: Massimo
authors: M
authors: Iacoviello
authors: School of Cardiology, University of Bari, Bari, Italy.
authors: Gaetano
authors: G
authors: Citarelli
authors: Cardiology Department, Bari Local Health Service, Bari, Italy.
authors: Valeria
authors: V
authors: Antoncecchi
authors: Emergency Cardiology Unit, Policlinic University Hospital, Bari, Italy.
authors: Roberta
authors: R
authors: Romito
authors: School of Cardiology, University of Bari, Bari, Italy.
authors: Francesco
authors: F
authors: Monitillo
authors: School of Cardiology, University of Bari, Bari, Italy.
authors: Marta
authors: M
authors: Leone
authors: Cardiology Department, Bari Local Health Service, Bari, Italy.
authors: Agata
authors: A
authors: Puzzovivo
authors: School of Cardiology, University of Bari, Bari, Italy.
authors: Maria Silvia
authors: MS
authors: Lattarulo
authors: School of Cardiology, University of Bari, Bari, Italy.
authors: Caterina
authors: C
authors: Rizzo
authors: Cardiology Department, Bari Local Health Service, Bari, Italy.
authors: Pasquale
authors: P
authors: Caldarola
authors: Cardiology Unit, Cardiothoracic Department, Policlinic University Hospital, Bari, Italy.|School of Cardiology, University of Bari, Bari, Italy.
authors: Marco Matteo
authors: MM
authors: Ciccone
mesh_terms: D015984:Causality; D002908:Chronic Disease; D015897:Comorbidity; D004452:Echocardiography / Q000379:methods / Q000706:statistics & numerical data; D054459:Elasticity Imaging Techniques / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D016019:Survival Analysis; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000401:mortality*
keywords: echocardiography; heart failure; myocardial strain; right ventricular function