Effects of Right Ventricular Ejection Fraction on Outcomes in Chronic Systolic Heart Failure

BACKGROUND: Studies of the effect of right ventricular ejection fraction (RVEF) on outcomes in heart failure (HF) are limited by small sample size and short follow-up. METHODS AND RESULTS: We examined the effect of baseline RVEF on outcomes in 2008 Beta-Blocker Evaluation of Survival Trial (BEST) participants with HF and left ventricular ejection fraction or=40% (n=733), 30% to 39% (n=531), 20% to 29% (n=473), and or=40%, 30% to 39%, 20% to 29%, and or=40%, unadjusted hazard ratios and 95% confidence intervals for all-cause mortality for those with RVEF 30% to 39%, 20% to 29%, and or=40%) were as follows: cardiovascular mortality, 1.33 (1.01 to 1.76; P=0.041); HF mortality, 1.61 (1.03 to 2.52; P=0.037); sudden cardiac death, 1.29 (0.87 to 1.91; P=0.212); all-cause hospitalization, 1.21 (1.00 to 1.47; P=0.056); and HF hospitalization, 1.39 (1.10 to 1.77; P=0.007). CONCLUSIONS: Baseline RVEF <20% is a significant independent predictor of mortality and HF hospitalization in systolic HF.