Right Ventricular Ejection Fraction for the Prediction of Major Adverse Cardiovascular and Heart Failure-Related Events

Author:

Purmah Yanish1,Lei Lucy Y.1ORCID,Dykstra Steven1,Mikami Yoko1ORCID,Cornhill Aidan1,Satriano Alessandro1ORCID,Flewitt Jacqueline1,Rivest Sandra1,Sandonato Rosa1,Seib Michelle1,Lydell Carmen P.12,Howarth Andrew G.13,Heydari Bobak13,Merchant Naeem12,Bristow Michael12,Fine Nowell13,Gaztanaga Juan4,White James A.123ORCID

Affiliation:

1. Stephenson Cardiac Imaging Centre, Libin Cardiovascular Institute of Alberta (Y.P., L.Y.L., S.D., Y.M., A.C., A.S., J.F., S.R., R.S., M.S., C.P.L., A.G.H., B.H., N.M., M.B., N.F., J.A.W.), Cumming School of Medicine, University of Calgary, Canada.

2. Department of Diagnostic Imaging (C.P.L., N.M., M.B., J.A.W.), Cumming School of Medicine, University of Calgary, Canada.

3. Department of Cardiac Sciences (A.G.H., B.H., N.F., J.A.W.), Cumming School of Medicine, University of Calgary, Canada.

4. Department of Medicine, New York University Winthrop, Mineola (J.G.).

Abstract

Background: There is increasing evidence that right ventricular ejection fraction (RVEF) may provide incremental value to left ventricular (LV) ejection fraction for the prediction of major adverse cardiovascular events. To date, generalizable utility for RVEF quantification in patients with cardiovascular disease has not been established. Using a large prospective clinical outcomes registry, we investigated the prognostic value of RVEF for the prediction of major adverse cardiovascular events- and heart failure-related outcomes. Methods: Seven thousand one hundred thirty-one consecutive patients with known or suspected cardiovascular disease undergoing cardiovascular magnetic resonance imaging were prospectively enrolled. Multichamber volumetric quantification was performed by standardized operational procedures. Patients were followed for the primary composite outcome of all-cause death, survived cardiac arrest, admission for heart failure, need for transplantation or LV assist device, acute coronary syndrome, need for revascularization, stroke, or transient ischemic attack. A secondary, heart failure focused outcome of heart failure admission, need for transplantation/LV assist device or death was also studied. Results: Mean age was 54±15 years. The mean LV ejection fraction was 55±14% (range 6%–90%) with a mean RVEF of 54±10% (range 9%–87%). At a median follow-up of 908 days, 870 (12%) patients experienced the primary composite outcome and 524 (7%) the secondary outcome. Each 10% drop in RVEF was associated with a 1.3-fold increased risk of the primary outcome ( P <0.001) and 1.5-fold increased risk of the secondary outcome ( P <0.001). RVEF was an independent predictor following comprehensive covariate adjustment, inclusive of LV ejection fraction. Patients with an RVEF<40% experienced a 3.1-fold risk of the primary outcome ( P <0.001) with a 1-year cumulative event rate of 22% versus 7% above this cutoff. Conclusions: RVEF is a powerful and independent predictor of major adverse cardiac events with broad generalizability across patients with known or suspected cardiovascular disease. These findings support migration towards biventricular phenotyping for the classification of risk in clinical practice. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04367220.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine,Radiology, Nuclear Medicine and imaging

Cited by 22 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3