•  
  •  
 

Subject Area

Cardiology and Vascular Medicine

Article Type

Original Study

Abstract

Objective To assess the utility of measuring right ventricular (RV) volumes and function by three-dimensional echocardiography (3DE) and speckle tracking in patients with nonischemic dilated cardiomyopathy (DCM). Background DCM represents a leading cause of heart failure and cardiac transplantation. The degree of left ventricular dilation and impairment in DCM patients is traditional determinants of adverse outcomes; moreover, many predictors have been established, for example, the presence of secondary functional mitral regurge, myocardial fibrosis, and enlargement of other chambers importantly the RV. The RV remodeling carries prognostic values to the progression and recovery of left ventricular remodeling in DCM patients. Recently, the 3DE gained an important role in the assessment of RV as it avoids geometric assumptions and offers superior reproducibility. Methods and results We prospectively enrolled 52 patients with nonischemic DCM. All patients underwent comprehensive clinical assessment, laboratory investigations, and transthoracic echocardiographic assessment by conventional echocardiography and 3DE assessment of RV volumes and ejection fraction. The mean age of patients was 45 ± 17 years. Of the patients, 61.5% were males and 38.5% were females. The median of brain natriuretic peptides was elevated to 1208 pg/dl with interquartile range (550–3227). The 3DE assessment of RV revealed increased mean RV volumes (end-diastolic volume 150 ± 59 ml, RVESV 95 ± 57 ml, and mean of RVEF of 42 ± 13%). In our study, 28 (54%) patients had impaired RV function by 3DE (RVEF <45%). In addition, the RV free wall strain was abnormal (<−20) in 27 patients. Conclusion The 3DE imaging has an evolved usefulness in RV volumetric function assessment and comes to be more comfortable, easier, and time saver than cardiac MRI. The RV3D assessment in patients with nonischemic DCM may carry a prognostic impact on cardiac outcomes in this critical group of patients.

Download

Share

COinS