The Prevalence and Prognostic Significance of Right Ventricular Systolic Dysfunction in Nonischemic Dilated Cardiomyopathy

• Published in: Circulation (New York, N.Y.) N.Y.), 2013-10, Vol.128 (15), p.1623-1633
• Main Authors: Gulati, Ankur, Ismail, Tevfik F., Jabbour, Andrew, Alpendurada, Francisco, Guha, Kaushik, Ismail, Nizar A., Raza, Sadaf, Khwaja, Jahanzaib, Brown, Tristan D.H., Morarji, Kishen, Liodakis, Emmanouil, Roughton, Michael, Wage, Ricardo, Pakrashi, Tapesh C., Sharma, Rakesh, Carpenter, John-Paul, Cook, Stuart A., Cowie, Martin R., Assomull, Ravi G., Pennell, Dudley J., Prasad, Sanjay K.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiomyopathy, Dilated - mortality; Cardiomyopathy, Dilated - pathology; Cardiomyopathy, Dilated - physiopathology; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Follow-Up Studies; Heart; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Humans; Kaplan-Meier Estimate; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Myocarditis. Cardiomyopathies; Predictive Value of Tests; Prevalence; Prognosis; Prospective Studies; Risk Factors; Stroke Volume - physiology; Ventricular Dysfunction, Right - mortality; Ventricular Dysfunction, Right - pathology; Ventricular Dysfunction, Right - physiopathology; Ventricular Function, Right - physiology
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/CIRCULATIONAHA.113.002518

BACKGROUND—Cardiovascular magnetic resonance is the gold-standard technique for the assessment of ventricular function. Although left ventricular volumes and ejection fraction are strong predictors of outcome in dilated cardiomyopathy (DCM), there are limited data regarding the prognostic significance of right ventricular (RV) systolic dysfunction (RVSD). We investigated whether cardiovascular magnetic resonance assessment of RV function has prognostic value in DCM. METHODS AND RESULTS—We prospectively studied 250 consecutive DCM patients with the use of cardiovascular magnetic resonance. RVSD, defined by RV ejection fraction ≤45%, was present in 86 (34%) patients. During a median follow-up period of 6.8 years, there were 52 deaths, and 7 patients underwent cardiac transplantation. The primary end point of all-cause mortality or cardiac transplantation was reached by 42 of 86 patients with RVSD and 17 of 164 patients without RVSD (49% versus 10%; hazard ratio, 5.90; 95% confidence interval [CI], 3.35–10.37; P