Role of right ventricular systolic function on long-term outcome in patients with newly diagnosed systolic heart failure

Background: right ventricular (rv) systolic function has been recognized as a prognostic factor in endstage heart failure (hf) patients and in the present study we evaluated the effect of this dysfunction on prognosis in patients with newly-diagnosed systolic hf. methods and results: we enrolled 180 consecutive patients with newly diagnosed systolic hf (ischemic or dilated cardiomyopathy). echocardiographic evaluation was performed to assess biventricular function. pulse-wave tissue doppler imaging (tdi) readings were obtained from the lateral tricuspid annulus and the peak systolic annular velocity (stv) was recorded. patients were followed for a 2-year period and events (death or hf hospitalization) were recorded. during the follow-up,79 patients (44%) had an adverse event. an inverse relationship was observed between the height of stv and the probability of an event (odds ratio (or) 0.716,95% confidence interval (ci) 0.583-0.880,p=0.001),after controlling for potential confounders. furthermore,creatinine clearance (crcl) was inversely associated with the outcome: a 1-unit increase in crcl was associated with a 0.98-times lower likelihood of having an event. when the analysis was stratified by crcl <60 ml/min or ≥60 ml/min,stv predicted adverse events in both groups (crcl <60 ml/min: or 0.62,95%ci 0.39-0.98,p=0.04; crcl ≥60 ml/min: or 0.78,95%ci 0.61-1.01,p=0.06). conclusions: pulse-wave tdi readings of peak systolic velocity at the lateral tricuspid annulus,reflecting rv systolic function,has prognostic significance in newly-diagnosed systolic hf patients.