Echocardigraphic assessment of right ventricular outflow tract function in patients with chronic heart failure

Background: Heart failure (HF) is a progressive , clinical disease where a subset of HF patients has symptoms unrelated to the hemodynamic status and left ventricular ejection fraction . The Right ventricular (RV) function is considered to be a reliable prognostic element in HF, although assessing it is a challenge because of the complexity of the RV. Objective: This study aimed to investigate the clinical application of RV outflow tract (RVOT) function measured by transthoracic echocardiography in HF patients. Method: The investigation of 80 chronic HF patients with dilated dimensions and left ventricular systolic dysfunction (EF less than 40%) ,and 20 healthy control subjects (normal ventricular function ,no risk factors and normal electrocardiogram). Where clinical and conventional echocardiographic parameters, RVOT dimensions and fractional shortening (RVOT-FS) were analyzed. Results: The RVOT-FS was less in HF patients than controls (34.4 ± 10.1 vs 57.5 ± 2.5, p < 0.001) and TAPSE correlated positively ( p < 0.001), inverse corelation with SPAP ( p < 0.001). There was a statistically significant difference in RVOT-FS among the HF subgroups with regard to NYHA functional capacity (p < 0.001), Although no significant difference regarding LVEF. Conclusion: Although the discordance between LVEF and the degree of functional impairment in HF is not well understood,it could be explained partly by alteration in RV function. It was found that the RVOT-FS is noninvasive and easily applicable measure of RV function and might be used in evaluation , prognosis and follow-up of HF patients with other RV parameters.