Prognostic Value of Right Ventricular Parameters in Patients with Left Ventricular Dysfunction undergoing Coronary Revascularization. A Longitudinal Study

1. Background
Data regarding risk stratification in patients
with LV dysfunction undergoing CABG
are scarce.
Objective: to compare echocardiographic,
functional and clinical parameters in order
to define independent predictors of long-
term outcome.
Methods
Doppler echocardiographic data, six-minute
walking test (6-MWT) and BNP data were
collected pre-operatively, at discharge and
at the follow-up in 137 patients (mean age=
68±6 y,) with LV dysfunction undergoing
CABG.
The population was divided in 2 groups:
group 1: n=84 with EF ≤ 35 %; group 2:
n=53 with EF≥35%.
Conclusions
Among all the collected variables, preoperative right ventricular mid-diameter and TAPSE are the main echocardiographic independent predictors of all-causes of death in patients with LV dysfunction
undergoing CABG. Our study shows the usefulness of right ventricular parameters for predicting the long-term outcome, and indicates that ventricular interactions may contribute to the outcome. Further
studies are warranted to elucidate these findings.
Conflicts of interest:none
Prognostic Value of Right Ventricular Parameters in Patients with Left Ventricular Dysfunction undergoing Coronary
Revascularization: a Longitudinal Study
Carlo Fino 1, Diego Cugola 1, Julien Magne 2, Attilio Iacovoni1, John Pepper 3, Alice Calabrese1, Massimo Caputo 4, Amedeo Terzi1, Lorenzo Galletti 1, Caterina Simon 1,
Diego Bellavia 5, Francesco Innocente 1, Samuele Pentiricci 1, Maurizio Merlo 1
1 Ospedale P. Giovanni XXIII, Bergamo, Italy; 2 CHU Limoges, Hôpital Dupuytren, Limoges, France; 3 Royal Brompton Hosp, London, UK; 4 Univ. of Bristol, Bristol, UK
5 Mediterranean Inst for Transplantation and Advanced Specialized Therapies , Palermo, Italy
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Median follow-up: 7.2 y (range: 0.2-15.7). Early mortality: 7%.
There was no difference in BNP level and 6MWT distance between groups
and according to the period (i.e. preoperative vs. discharge vs. follow-up).
The multivariate Cox proportional Hazard model, after adjustment for
cofactors, identified advanced age (HR: 1.12, 95%CI: 1.02-1.22, p=0.01),
preoperative peak transmitral gradient (HR= 1.88, 95%CI: 1.72-4.13,
p=0.001), preoperative TAPSE: HR=0.21, 95%CI: 0.04-1.07, p=0.04),
preoperative mid RV diameter (HR=1.27, 95%CI: 1.01-1.60, p=0.04) and
preoperative BNP levels (HR=1.00, 95%CI: 1.00-1.01, p=0.01) as
independent predictors of all-causes of death.
Kaplan-Meier Survival Estimates
Outcome: All-Causes Mortality Results
EF>35% EF<35%