Lack of right ventricular hypertrophy is associated with right heart failure in patients with left ventricular failure

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Date
2022Author
Naser, AbdulrahmanIsgandarov, Khagani
Guvenc, Tolga Sinan
Ekmekci, Ahmet
Gunduz, Sabahattin
Guvenc, Rengin Cetin
Sahin, Muslum
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Naser A, Güvenç TS, Isgandarov K, Ekmekçi A, Gündüz S, Çetin Güvenç R, Şahin M. Lack of right ventricular hypertrophy is associated with right heart failure in patients with left ventricular failure. Heart Vessels. 2022 Apr 26. doi: 10.1007/s00380-022-02075-2. Epub ahead of print. PMID: 35471461.Abstract
Presence of right heart failure (RHF) is associated with a worse prognosis in patients with left ventricular failure (LVF).
While the cause of RHF secondary to LVF is multifactorial, an increased right ventricular (RV) afterload is believed as
the major cause of RHF. However, data are scarce on the adaptive responses of the RV in patients with LVF. Our aim was
to understand the relationship of right ventricular hypertrophy (RVH) with RHF and RV systolic and diastolic properties
in patients with LVF. 55 patients with a left ventricular ejection fraction of 40% or less were included in the present study.
A comprehensive two-dimensional transthoracic echocardiographic examination was done to all participants. 12 patients
(21.8%) had RHF, and patients with RHF had a signifcantly lower right ventricular free wall thickness (RVFWT) as compared
to patients without RHF (5.3±1.7 mm vs. 6.6±0.9 mm, p=0.02) and the diference remained statistically signifcant after
adjusting for confounders (Δx̅:1.34 mm, p=0.002). RVFWT had a statistically signifcant correlation with tricuspid annular
plane systolic excursion (r=0.479, p<0.001) and tricuspid annular lateral systolic velocity (r=0.360, p=0.007), but not
with the indices of the RV diastolic function. None of the patients with concentric RVH had RHF, while 22.2% of patients
with eccentric RVH and 66.7% of patients without RVH had RHF (p<0.01 as compared to patients with concentric RVH).
In patients with left ventricular systolic dysfunction, absence of RVH was associated with worse RV systolic performance
and a signifcantly higher incidence of RHF
Source
Heart and VesselsVolume
37Issue
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