What question did this study set out to answer?

Determine normal values and assess the prognostic utility of right ventricular 2D strain in patients with chronic heart failure.

October 27, 2011Circulation JournalOpen Access

Prognostic Significance and Normal Values of 2D Strain to Assess Right Ventricular Systolic Function in Chronic Heart Failure

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Why the study?

Does RV-2D strain predict adverse clinical outcomes in patients with chronic heart failure?

Population

161 participants including 43 controls and 118 stable chronic heart failure patients

Design

Cohort

Follow-up

mean 37±14 months

Authors

SGSoulef GuendouzUniversité Paris-Est Créteil SRStéphane RappeneauDélégation Paris 5 JNJulien NahumInserm

Discussion

Member takes

Implication

May refine risk stratification in chronic HF; hypothesis-generating and requires prospective validation before clinical adoption.

Key Points

Determine normal values and assess the prognostic utility of right ventricular 2D strain in patients with chronic heart failure.
Prospectively enrolled 43 healthy controls and 118 stable chronic heart failure patients between 2005 and 2010.
Measured standard echocardiographic parameters, TAPSE, peak systolic velocity via tissue Doppler imaging, and right and left ventricular 2D strain.
Followed patients for a mean of 37±14 months to track a primary outcome of death, emergency transplantation, emergency ventricular assist device implantation, or acute heart failure.
Right ventricular 2D strain was measurable in 39 controls with a median of 30% (95% CI, 39% to 20%) and in 104 heart failure patients with a median of 19% (95% CI, 34% to 9%).
During follow-up, 44 patients experienced the primary outcome, with multivariate analysis confirming right ventricular 2D strain and log B-type natriuretic peptide as the sole independent predictors of events within the first year.
Receiver-operating characteristics identified a right ventricular 2D strain cutoff of 21%, with values above 21% indicating the greatest risk of adverse outcomes (χ² log-rank = 14.1, P < 0.0001).

Structured PICO

Does RV-2D strain predict adverse clinical outcomes in patients with chronic heart failure?

Population

161 participants including 43 controls (mean age 58±17, 50% men) and 118 stable chronic heart failure patients (mean age 57±11, 80% men, mean LVEF 29%±8%)

Intervention

Right ventricle (RV)-2D strain measurement using echocardiography

Outcome

Composite of death or emergency transplantation or emergency ventricular assist device implantation or acute heart failurecomposite

RV-2D strain is a strong independent predictor of severe adverse events in patients with chronic heart failure, potentially superior to other RV or LV echocardiographic variables.

Cite This Study

Guendouz et al. (2011) studied this question.

synapsesocial.com/papers/6a7d1699d3686d25b46e48c2 https://doi.org/10.1253/circj.cj-11-0778

Topics

Mechanical circulatory support Heart transplantation Heart failure HFrEF treatment

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Prognostic Significance and Normal Values of 2D Strain to Assess Right Ventricular Systolic Function in Chronic Heart Failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Prognostic Significance and Normal Values of 2D Strain to Assess Right Ventricular Systolic Function in Chronic Heart Failure

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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