Key result
RV GLS and free wall strain predict HFrEF mortality with ~0.84 AUC.
Why the study?
Right ventricular dysfunction predicts poor prognosis in left ventricular failure, but its relationship with early in-hospital and post-discharge clinical events in low ejection fraction heart failure requires investigation.
Does right ventricular dysfunction assessed by RV Global Longitudinal Strain and RV Free Wall Strain predict early clinical events and mortality in patients hospitalized with decompensated low ejection fraction heart failure?
Observational (n=70)
No
Does right ventricular dysfunction assessed by RV Global Longitudinal Strain and RV Free Wall Strain predict early clinical events and mortality in patients hospitalized with decompensated low ejection fraction heart failure?
Effect estimate: AUC 0.837 (95% CI 0.729-0.914)
p-value: p=<0.001
Right ventricular global longitudinal strain and free wall strain are strong predictors of early clinical events and mortality in patients hospitalized with decompensated low ejection fraction heart failure.
RV strain may refine mortality prediction in decompensated HFrEF; leaves open whether it alters management or outcomes.
Background and aim Right ventricular dysfunction is an independent predictor of poor prognosis in the patients with left ventricle failure. In this study, it is aimed to investigate the relationship between RV functions and early clinical events in hospital and after discharge in patients who were followed up for heart failure with a low ejection fraction and were hospitalized with the diagnosis of heart failure. Materials and methods Seventy patients with a left ventricular ejection fraction below 45% who were hospitalized due to decompensated heart failure were enrolled in this study. They were stabilized after medical treatment and discharged. Thereafter, they were followed up for 6 months in terms of clinical events. Image windows used as standard in the 2D echocardiography technique were recorded while the related technique was being performed. Results Composite adverse events were observed in 45 patients (64.3%), while composite adverse events were not observed in 25 patients (35.7%). Relation between the independent risk factors and composite adverse events were analyzed with binary logistic regression analysis. Receiver Operating Characteristic (ROC) analysis was performed to determine the distinctive performance of right ventricular (RV) Global Longitudinal Strain (GLS) and RV Free Wall Strain (FWS) parameters in the prediction of mortality in patients. RV Global LS ( p < 0.001) and RV Free W Strain ( p < 0.001) were determined as distinguishing factors related with mortality. Conclusion We found that RV GLS and RV fwLS are closely related. Moreover, both measurements were correlated not only with parameters reflecting RV systolic function, but also with parameters reflecting LV function.
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Onac et al. (2025) conducted an observational in Low ejection fraction heart failure (n=70). Right ventricular global longitudinal strain (RV GLS) and free wall strain (RV FWS) assessment was evaluated on Mortality prediction by RV Global Longitudinal Strain (AUC 0.837, 95% CI 0.729-0.914, p=<0.001). Right ventricular global longitudinal strain and free wall strain were significant predictors of mortality in patients with low ejection fraction heart failure, with AUCs of 0.837 and 0.816 respectively.
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