RV Ejection Fraction (rv + ejection_fraction)

Distribution by Scientific Domains


Selected Abstracts


Right Ventricular Function in Congenital Heart Defects Assessed by Regional Wall Motion

CONGENITAL HEART DISEASE, Issue 3 2010
FSCAI, Michael R. Nihill MB
ABSTRACT Objectives., To develop a simple method to assess right ventricular function by angiography. Background., Conventional methods of evaluating right ventricular function are inaccurate, cumbersome, and expensive. Methods., We analyzed biplane right ventricular angiograms taken in the posterior,anterior and lateral projections using software to measure right ventricular volumes and regional wall motion in 78 patients with normal hearts (n = 29), atrial septal defects (ASD n = 13), pulmonary valve stenosis (PVS n = 21), and postoperative atrial switch patients (n = 15). We also measured the shortening fraction (SF) from the midtricuspid annulus to the septum and correlated various angiographic measurements with the right ventricular (RV) ejection fraction. Results., The volume-overloaded patients (ASD) had larger end diastolic volumes and increased SF compared with normal patients, while the pressure-loaded patients (PVS) had normal volumes and SF. The postoperative atrial switch patients had decreased systolic function and increased end diastolic volume. The SF for all of the patients correlated with the ejection fraction (r= 0.785, P, .0001). Conclusions., A simple measurement of the end diastolic and end systolic distance from the midtricuspid annulus to the septum (SF) provides a good index of RV function by angiography and correlates well with RV ejection fraction. [source]


Presence of Biventricular Dysfunction in Patients With Type II Diabetes Mellitus

CONGESTIVE HEART FAILURE, Issue 2 2007
Mohammad-Reza Movahed MD
Diabetes mellitus (DM) has been found to be associated with depressed left ventricular (LV) function. Right ventricular (RV) function in DM patients, however, has not been well studied. The goal of this study was to evaluate the occurrence of LV and RV dysfunction in patients with DM. A series of 157 patients underwent simultaneous measurement of LV ejection fraction (LVEF) and RV ejection fraction (RVEF). Four of 26 DM patients had RVEF <30% (15.4%) vs 4 of 126 controls (3.2%) (P=.01). Eleven of 27 (40.7%) patients with DM had LVEF <30% vs 9 of 128 controls (7%) (P<.0001). Using multivariate analysis, DM remained independently associated with severely decreased biventricular function (RVEF <30%; odds ratio, 5.7; confidence interval, 1.3,25.4 [P=.02] and LVEF <30%; odds ratio, 12.9; confidence interval, 3.8,43.7 [P<.0001]). These results suggest that diabetic cardiomyopathy involves both ventricles as an independent pathologic process. [source]


Two-Dimensional Assessment of Right Ventricular Function: An Echocardiographic,MRI Correlative Study

ECHOCARDIOGRAPHY, Issue 5 2007
Nagesh S. Anavekar M.D.
Background: While echocardiography is used most frequently to assess right ventricular (RV) function in clinical practice, echocardiography is limited in its ability to provide an accurate measure of RV ejection fraction (RVEF). Hence, quantitative estimation of RV function has proven difficult in clinical practice. Objective: We sought to determine which commonly used echocardiographic measures of RV function were most accurate in comparison with an MRI-derived estimate of RVEF. Methods: We analyzed RV function in 36 patients who had cardiac MRI studies and echocardiograms within a 24 hour period. 2D parameters of RV function,right ventricular fractional area change (RVFAC), tricuspid annular motion (TAM), and transverse fractional shortening (TFS) were obtained from the four-chamber view. RV volumes and EFs were derived from volumetric reconstruction based on endocardial tracing of the RV chamber from the short axis images. Echocardiographic assessment of RV function was correlated with MRI findings. Results: RVFAC measured by echocardiography correlated best with MRI-derived RVEF (r = 0.80, P < 0.001). Neither TAM (r = 0.17; P = 0.30) nor TFC (r = 0.12; p< 0.38) were significantly correlated with RVEF. Conclusions: RVFAC is the best of commonly utilized echocardiographic 2D measure of RV function and correlated best with MRI-derived RV ejection fraction. Condensed Abstract: While echocardiography is used most frequently to assess RV function in clinical practice, echocardiography is limited in its ability to provide an accurate measure of RV ejection fraction (RVEF). Using cardiac MRI, RV fractional area change (RVFAC), determined either by MRI or echocardiography, was found to correlate best with MRI-derived RVEF. [source]


Limited Response to Cardiac Resynchronization Therapy in Patients with Concomitant Right Ventricular Dysfunction

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 4 2010
M.P.H., PAUL B. TABEREAUX M.D.
Limited Response to CRT in Patients with RVD.,Introduction: Patients with left ventricular dysfunction (LVD) and LV dyssynchrony may respond to cardiac resynchronization therapy (CRT). However, right ventricular dysfunction (RVD) is a predictor of decreased survival in patients with LVD, and its influence on clinical response to CRT is unknown. The purpose of this study was to examine the effect of RVD on the clinical response to CRT. Methods and Results: A retrospective cohort of consecutive patients who underwent implantation of a CRT implantable cardioverter-defibrillator (ICD) were included and deemed to have RVD based on a RV ejection fraction <0.40. A lack of response to CRT was defined as: death, heart transplantation, implantation of an LV assist device, absent improvement in NYHA functional class at 6 months or hospice care. Among 130 patients included (mean age 58 ± 11 years, 68.5% male, 87.7% Caucasian, 51.5% nonischemic cardiomyopathy), 77 (59.2%) had no response to CRT as defined above. Of the nonresponders, 43 (56%) had RVD and 34 (44%) did not have RVD (P = 0.02). After adjustment for age, race, gender, cardiomyopathy type, atrial fibrillation, serum sodium, and severe mitral regurgitation, RVD (adjusted OR = 0.34, 95%CI 0.14,0.82), female gender (adjusted OR = 0.36, 95%CI 0.14,0.95), and serum creatinine (adjusted OR = 0.25, 95%CI 0.09,0.71) were independently associated with decreased odds of response to CRT. There was a significant difference in survival of patients with and without RVD after CRT (log rank P = 0.01). Conclusion: RVD represents a strong predictor of lack of clinical response to CRT in patients with CHF due to LVD and should be considered when prescribing CRT. (J Cardiovasc Electrophysiol, Vol. 21, pp. 431,435, April 2010) [source]


Assessment of a New Experimental Model of Isolated Right Ventricular Failure

ARTIFICIAL ORGANS, Issue 3 2009
Petronio G. Thomaz
Abstract We assessed a new experimental model of isolated right ventricular (RV) failure, achieved by means of intramyocardial injection of ethanol. RV dysfunction was induced in 13 mongrel dogs via multiple injections of 96% ethanol (total dose 1 mL/kg), all over the inlet and trabecular RV free walls. Hemodynamic and metabolic parameters were evaluated at baseline, after ethanol injection, and on the 14th postoperative day (POD). Echocardiographic parameters were evaluated at baseline, on the sixth POD, and on the 13th POD. The animals were then euthanized for histopathological analysis of the hearts. There was a 15.4% mortality rate. We noticed a decrease in pulmonary blood flow right after RV failure (P = 0.0018), as well as during reoperation on the 14th POD (P = 0.002). The induced RV dysfunction caused an increase in venous lactate levels immediately after ethanol injection and on the 14th POD (P < 0.0003). The echocardiogram revealed a decrease in the RV ejection fraction on the sixth and 13th PODs (P = 0.0001). There was an increased RV end-diastolic volume on the sixth (P = 0.0001) and 13th PODs (P = 0.0084). The right ventricle showed a 74% ± 0.06% transmural infarction area, with necrotic lesions aged 14 days. Intramyocardial ethanol injection has allowed the creation of a reproducible and inexpensive model of RV failure. The hemodynamic, metabolic, and echocardiographic parameters assessed at different protocol times are compatible with severe RV failure. This model may be useful in understanding the pathophysiology of isolated right-sided heart failure, as well as in the assessment of ventricular assist devices. [source]