Cor Vasa 2006, 48(9):305-310 | DOI: 10.33678/cor.2006.101

Risk stratification in patients with chronic heart failure by assessment of right ventricular isovolumic relaxation time using tissue Doppler imaging

Vladimír Kincl^1,*, Jaroslav Meluzín¹, Lenka Špinarová¹, Petr Hude¹, Jan Krejčí¹, Roman Panovský¹, Jiří Jarkovský², Ladislav Dušek²

¹ I. interní-kardioangiologická klinika, Fakultní nemocnice u sv. Anny

² Centrum biostatistiky a analýz Masarykovy univerzity, Brno, Česká republika

Aim:
The purpose of this study was to determine the importance of right ventricular isovolumic relaxation time (RV IVRT) measured by tissue Doppler imaging of tricuspid annular motion in the risk stratification in patients with chronic heart failure.

Methods:
In all, 108 patients with symptomatic heart failure and mean ejection fraction of 24% underwent standard echocardiographic examination, Doppler tissue imaging of tricuspid annular motion, and right-heart catheterization. The patients were followed up for a mean period of 18 months for cardiac-related death and non-fatal cardiac events including the implantation of a cardioverter/defibrillator and hospitalization for heart failure decompensation.

Results:
The total number of cardiac events was 31; 12 patients died, 19 had non-fatal cardiac event as described above. Statistical analysis showed significant differences in RV IVRT (98 ± 62 vs 62 ± 32 ms; p < 0.05), pulmonary artery pressure (25.2 ± 11.2 vs 32.3 ± 8.0 mm Hg; p < 0.05), and pulmonary capillary wedge pressure (17.0 ± 9.1 vs 23.5 ± 7.3 mm Hg; p < 0.05) between survivors and deceased patients. When analyzing the significance of parameters for prediction of event or death risk, mean pulmonary artery pressure (AP) and pulmonary capillary wedge pressure (PCW) were the only parameters significantly related to the risk of event (AP p < 0.001; PCW p < 0.001) or death (AP p = 0.009; PCW p = 0.006); nevertheless, a trend for RV IVRT (p = 0.069) was found in predicting the risk of death.

Conclusion:
The RV IVRT obtained by tissue Doppler imaging can only be used as an auxiliary method of risk stratification in patients with heart failure.

Keywords: Tissue Doppler; Heart failure; Risk stratification

Published: September 1, 2006  Show citation