Portal de Periódicos da CAPES

Right ventricular function is independently related to exercise capacity in advanced heart failure

2013; Oxford University Press; Volume: 34; Issue: suppl 1 Linguagem: Inglês

10.1093/eurheartj/eht309.p3377

1522-9645

Beata Zaborska, Krzysztof Smarż, Aleksandra Czepiel, Maciej Świątkowski, Ewa Makowska, Tomasz Chamiec, Andrzej Budaj,

Cardiovascular Function and Risk Factors

Purpose: Data on impact of right ventricular (RV) function on exercise capacity (EC) in advanced heart failure (HF) with severe left ventricular (LV) dysfunction is limited. The aim was to assess impact of RV function on EC in candidates for cardiac resynchronization therapy (CRT). Methods: Patients (pts) (n=67, 81% males, mean age 66.7±8.9, 75% ischaemic cardiomiopathy)with symptomatic HF, NYHA II-IV, ejection fraction (EF) ≤35%, fulfilling standard criteria for CRT were prospectively assessed. Echocardiography and cardiopulmonary exercise test (CPET)were done before CRT. Oxygen uptake at peak exercise (peak VO2) expressed in L/min and in ml/kg/min, and percent of predictive values (VO2 max. predicted) were assessed as EC parameters. RV function was assessed as TAPSE, fractional area change (FAC) and systolic myocardial velocity of RV free wall (SmRV). Impact of RV function parameters on EC was evaluated with multivariate regression analysis. Age, sex, all RV and LV function parameters: EF, dP/dt, end systolic volume (LVESV), degree of mitral regurgitation (MR) and ratio E/E' were included into the model. Results: RV function was characterized by TAPSE 19.8±3.9 mm, SmRV 10.1±2.6 cm/s and FAC 38.5±13%. LV function parameters were as follows: EF 25.8±7%, dP/dt 547.7±140mmHg/s, LVESV 155.7±57.8 ml, E/E' 14.8±8. MR was assessed as mild in 52% pts, moderate in 30% pts and severe in 15% pts. Mean peak VO2 for the whole group was 0.94±0.37 in L/min and 11.75±3.16 in ml/kg/min. Ratio to predictive values was 67.1±18% and 57.8±19.4%, respectively. SmRV was found to influence independently EC parameters (Tab.). Degree of MR was found to be significant but weaker factor for lower EC. No significant effect was shown for other tested RV and LV parameters. Table 1 Conclusion: RV function assessed as systolic myocardial velocity independently of LV function parameters has significant impact on exercise capacity in advanced HF.