Right ventricular echocardiographic predictors of functional capacity in patients with heart failure with reduced ejection fraction

Abstract

Patients with chronic heart failure (CHF) experience marked reduction in their exercise capacity which has detrimental effects on their activities of daily living, health- related quality of life (HRQoL), and ultimately their hospital admission rate and mortality. This study aimed to determine the correlation between right ventricular echocardiographic variables, functional status assessed by 6 min walk distance (6MWD) and quality of life assessed by MLHFQ in HF patients.

Methods

Methods 70 patients with chronic stable HF with (EF ≤40%) presenting with grade I to III NYHA classification. Each patient performed a 6 min walk test (6MWT) and completed a form of MLHFQ. Patients classified into 2 groups according to the results of 6MWD (group A including those who walked > 300meters, While group B including those who walked < 300 meters), all patients were subjected to ECG gated echocardiographic study for assessment of systolic and diastolic functions of right ventricle (RV) and left ventricle (LV).

Results

We found a significant statistical relationship between the 6MWD and NYHA class (p < 0.001), there was a significant negative correlation between 6MWD and total score of MLHFQ (p=0.009) , There was a significant statistical difference between both groups and LAD (p=0.013) and mitral E/A ratio (p=0.01) as regards LV echocardiographic parameters (both being higher in group A) .There was a significant statistical difference between both groups as regards RVFAC, tricuspid E/e` of RV, TAPSE, SPAP, RAP and RV dilatation, (with PASP and TAPSE have higher statistical significance, P value < 0.001 and 0.005; respectively).

Conclusion

NYHA classes and MLHFQ score showed good predictive validity for functional status measured by 6MWT. In patients with heart failure with reduced EF (HFrEF), RV echocardiographic parameters (PASP and TAPSE) strongly correlate with 6MWT and accordingly functional status in these patients.

Imprint

Wael Tawfek, Karim Elakabawi, Hamza M. Kabil, Tarek H. Abo EL Azm, Ahmed Ramzy, Mostafa M. Khalil. Right ventricular echocardiographic predictors of functional capacity in patients with heart failure with reduced ejection fraction. Cardiometry; Issue 17; November 2020; p.127-134; DOI: 10.12710/cardiometry.2020.17.127134; Available from: http://www.cardiometry.net/issues/no17-november-2020/echocardiographic-predictors