Right ventricular systolic and diastolic function in heart failure with preserved ejection fraction

Abstract

Background: Heart failure (HF) with preserved ejection fraction (EF) has recently become an important health problem. It has been established as a major cause of cardiovascular morbidity and mortality. In heart failure with reduced ejection fraction right ventricular dysfunction is common and is associated with impaired functional capacity and poor prognosis. Aim: The aim of this work was to study the right ventricular systolic and diastolic functions in patients with heart failure and preserved left ventricular ejection fraction. Methods: We included fifty patients with heart failure with preserved ejection fraction (HFpEF), “diastolic heart failure” (LVEF ≥ 50%) and fifty normal subjects, comparable for sex and age. All subjects underwent blood pressure measurement, laboratory blood tests, complete right ventricle (RV) and conventional left ventricle (LV) 2D echocardiographic study. Results: The prevalence of right ventricular (RV) systolic dysfunction in patients with heart failure was 30, 34, 32 and 36%, by using right ventricular fractional area change (RV FAC), tricuspid annular plane systolic excursion (TAPSE), peak systolic tricuspid annular tissue velocity (S') and tissue Doppler myocardial performance index (TD MPI) criteria, respectively. The prevalence of right ventricular diastolic dysfunction studied by pulsed and tissue Doppler echocardiography was 64, 32, and 48%, using tricuspid E/A ratio (T E/A), tricuspid deceleration time (TDT) and tricuspid E/E' ratio (T E/E') criteria, respectively. Conclusion: The prevalence of right ventricular systolic and diastolic dysfunctions was not uncommon in patients with heart failure with preserved ejection fraction.