الفهرس | Only 14 pages are availabe for public view |
Abstract THE AIM OF OUR STUDY: 1. To assess the three-dimensional echocardiographic volumes and function of the right ventricle in the patients with non-ischemic dilated cardiomyopathy and its prognostic value of three-dimensional echocardiographic assessment of the right ventricle in predicting the outcomes. 2. To assess the global and regional changes in RV structure and function by 3D echocardiography in the patients with NIDCM. METHODS: A total of 52 patients with non-ischemic DCM were studied. Baseline clinical assessment, laboratory investigations (including BNP) and echocardiographic assessment; by conventional 2D echocardiography and three-dimensional assessments of right ventricular volumes and ejection fraction, LV dimensions and function and 2D speckle tracking of RV septal and free walls and global longitudinal and circumferential LV strain were done. The patients were followed up for median 2 years duration for primary outcomes including cardiac death and MACE. Summary 82 RESULTS: The mean age of patients was 45 years ± 17 years; 61.5% of the patients were males and 38.5% were females. The mean of left ventricular ejection fraction was 30%±6. The 3D RV assessment revealed an increased the mean of RV volumes and impaired RV ejection fraction was 42 ± 13% and the median of RV septal and lateral strain were impaired too (-9.5 and -19 successively). With median 2 years follow up; 17 patients (32.7%) reached the primary composite outcomes. Compared to patients without events; the patients with primary outcome had significantly increased RV volumes (RV end-diastolic volume 184±61ml vs. 138±55ml, p=0.001 and RV end-systolic volumes 126±65 vs. 83±53 p=0.001) and significantly lower ejection fraction (33±12% vs. 46±12%, p=0.001). Interestingly the RVEF was an independent predictor for outcomes. The RVEF ≤38% predicts the outcome with a sensitivity of 88.2% and a specificity of 82.8% (P value < 0.001). CONCLUSION: The study showed that 3D echocardiographic assessment of the RV volumes and function is crucial in the patients with dilated cardiomyopathy and has prognostic value in predicting the outcomes in this vulnerable group of patients. RVEF was an independent predictor; RVEF ≤38% could predict the prognosis. |