Right ventricular longitudinal systolic dysfunction is associated with worse clinical outcomes in acute dyspnea patients

Introduction: Acute right ventricular (RV) failure is a complex clinical syndrome which has been poorly studied worldwide. So far just few data have been pub- lished on the incidence and characteristic of the RV dysfunction including its association with clinical outcomes, functional parameters of left ventricle (LV) and co-morbidities.urpose: To evaluate the association of longitudinal RV systolic dysfunction (RVSD) with 1-year rehospitalisations and deaths in patients with acute dyspnea; to study clinical findings and co-morbidities typical for patients having RVSD. Methods: Prospective multicentre observational cohort study enrolled consecu- tive patients admitted to the emergency department in two university hospitals with acute dyspnea due to decompensated heart failure, exacerbation of chronic obstructive pulmonary disease, pneumonia, pulmonary embolism and other con- ditions. Demographic, clinical, echocardiographic data, co-morbidities and clinical outcomes of 307 patients were included in the analysis. Echocardiography was per- formed during the first 48 hours after the presentation to hospital. The longitudinal RVSD was defined by reduced tricuspid annular plane systolic excursion (TAPSE) of < 17 mm. Rehospitalisations and deaths were assessed after 1-year follow-up period. For statistical analysis Mann Whitney U and Pearson Chi-Square tests were used. P-value < 0.05 was considered statistically significant. Kaplan-Meier curves illustrate the survival analysis. Results: In analysed cohort mean age was 69.1 ± 12.3 years and 189 pts (61.56%) were female. The first (I) study group consisted of 166 (54.1%) patients with longitudinal RVSD; in the second (II) group 141 (45.9 %) patients had normal RV longitudinal function (TAPSE ≥ 17 mm). Rehospitalisations and deaths in 1-year follow-up period occurred significantly more often in the group with longitudinal RV dysfunction than in group II: 37 (15.0 %) vs. 14 [...]