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Multiparametric right ventricular evaluation, including BNP and echocardiography, provides useful but distinct prognostic information across different models of heart failure.
To evaluate the role of right ventricular function in different clinical models of heart failure. 22 patients with pulmonary hypertension (PH) in WHO class III and IV (group A) were evaluated by echocardiography, brain natriuretic peptide (BNP) measurements and right heart catheterization at baseline and after a mean follow-up of 15±4 months. 63 patients with chronic heart failure of different etiology, NYHA class IIIb–IV, followed-up for 18±3 months (group B), underwent echocardiography, BNP measurements, right heart catheterization at study entry and follow-up. In group A patients, among hemodynamic parameters consistent with severe PH, right atrial pressure significantly increased (from 6.7±4.8 to 10±6.5 mmHg, p<0.01); BNP showed a negative correlation with right ventricular ejection fraction (r2=0.46). In group B, mean left and right ventricular (thermodilution) ejection fraction (RVEF) were 21±7% and 18±9%; BNP showed significant correlations with pulmonary wedge pressure (r=0.48, p=0.02) and right ventricular function indices (RVEF and tricuspidal annular plane systolic excursion). A multiparametric right ventricular evaluation is useful even if several diagnostic and prognostic variables which were investigated in this study are not likely to show the same prognostic role in right and biventricular models of heart failure.
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Campana et al. (2004) studied this question.
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