Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Oct 8;128(15):1623-33.
doi: 10.1161/CIRCULATIONAHA.113.002518. Epub 2013 Aug 21.

The prevalence and prognostic significance of right ventricular systolic dysfunction in nonischemic dilated cardiomyopathy

Ankur Gulati  1 , Tevfik F Ismail, Andrew Jabbour, Francisco Alpendurada, Kaushik Guha, Nizar A Ismail, Sadaf Raza, Jahanzaib Khwaja, Tristan D H Brown, Kishen Morarji, Emmanouil Liodakis, Michael Roughton, Ricardo Wage, Tapesh C Pakrashi, Rakesh Sharma, John-Paul Carpenter, Stuart A Cook, Martin R Cowie, Ravi G Assomull, Dudley J Pennell, Sanjay K Prasad
Affiliations
Free article

The prevalence and prognostic significance of right ventricular systolic dysfunction in nonischemic dilated cardiomyopathy

Ankur Gulati et al. Circulation. .
Free article

Abstract

Background: Cardiovascular magnetic resonance is the gold-standard technique for the assessment of ventricular function. Although left ventricular volumes and ejection fraction are strong predictors of outcome in dilated cardiomyopathy (DCM), there are limited data regarding the prognostic significance of right ventricular (RV) systolic dysfunction (RVSD). We investigated whether cardiovascular magnetic resonance assessment of RV function has prognostic value in DCM.

Methods and results: We prospectively studied 250 consecutive DCM patients with the use of cardiovascular magnetic resonance. RVSD, defined by RV ejection fraction≤45%, was present in 86 (34%) patients. During a median follow-up period of 6.8 years, there were 52 deaths, and 7 patients underwent cardiac transplantation. The primary end point of all-cause mortality or cardiac transplantation was reached by 42 of 86 patients with RVSD and 17 of 164 patients without RVSD (49% versus 10%; hazard ratio, 5.90; 95% confidence interval [CI], 3.35-10.37; P<0.001). On multivariable analysis, RVSD remained a significant independent predictor of the primary end point (hazard ratio, 3.90; 95% CI, 2.16-7.04; P<0.001), as well as secondary outcomes of cardiovascular mortality or cardiac transplantation (hazard ratio, 3.35; 95% CI, 1.76-6.39; P<0.001), and heart failure death, heart failure hospitalization, or cardiac transplantation (hazard ratio, 2.70; 95% CI, 1.32-5.51; P=0.006). Assessment of RVSD improved risk stratification for all-cause mortality or cardiac transplantation (net reclassification improvement, 0.31; 95% CI 0.10-0.53; P=0.001).

Conclusions: RVSD is a powerful, independent predictor of transplant-free survival and adverse heart failure outcomes in DCM. Cardiovascular magnetic resonance assessment of RV function is important in the evaluation and risk stratification of DCM patients.

Keywords: cardiomyopathies; heart failure; magnetic resonance imaging; prognosis; ventricular function, right.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

Publication types

MeSH terms