Assessment of Right Ventricular functions by Echocardiography in patients with chronic heart Failure

Abstract

SUMMARY S tudies in heart failure (HF) generally focus on the functional assessment of the left ventricle. Conversely, the right ventricle has received far less attention in the evaluation of HF patients. Much of this neglect stems from the fact that the right ventricle has complex structural and physiological properties that pose challenges for the assessment of its morphology and function. So we aimed in this study to focus on right ventricle to review the alterations of cardiac right ventricular function associated with chronic heart failure and to predict incidence of right ventricular systolic dysfunction in patients with chronic heart failure. We studied 100 patients with left side heart failure due to dilated cardiomyopathy, there were 83 males and 17 females, their ages ranged from 20 to 73 years old, as we excluded patients who had other than sinus rhythm, who had pacemaker or defibrillator, whose ECGs contained right bundle branch block or left bundle branch block and who had severe tricuspid regurge as all patients included in the study were subjected to detailed history and clinical examination with special emphasis on age, gender and Risk Factors for cardio vascular disease as hypertension, diabetes mellitus, smoking and dyslipidemia. We measured JVP, observed presence of lower limb edema and classified our patients according to NYHA classification.

Then transthoracic echocardiography was done to all patients to predict the incidence of right ventricular dysfunction in our patients to classify our patients into 2 groups (group A and group B) according to prescence of impaired right ventricular systolic function which diagnosed By FAC, TAPSE, S wave, Then our data were statistically analysed using the statistical package For social science (SPSS), continous variables were presented as Mean + standard deviation and categorical variables as absolute Numbers by Chi – square test to compare between both groups as we found that our patients in group b had elevated JVP and lower limb edema more than group A, LV diastolic dysfunction was more common in group B, also TR was more severe and RVSP was higher in group B, and RV dimensions were higher and LVEF was lower in group B.