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Prognostic value of right ventricular ejection fraction assessed by transthoracic 3D echocardiography
Methods and Results: In protocol 1, we determined the accuracy of RV volumes and RV ejection fraction measurements by 3DTTE against cardiac magnetic resonance in 60 subjects. In protocol 2, 3DRVEF was measured in 446 patients with various cardiovascular diseases. Study subjects were followed up to record cardiac death and major adverse cardiovascular events. In protocol 1, 3DTTE-determined RV end-diastolic volume, end-systolic volume, and RV ejection fraction had good correlations to those by cardiac magnetic resonance (r = 0.74-0.90). In protocol 2, 38 cardiac deaths and 88 major adverse cardiovascular events occurred during a median follow-up of 4.1 years. Univariable Cox proportional analysis revealed that 3DRVEF was associated with both cardiac death (P < 0.0001) and major adverse cardiovascular event (P < 0.0001). 3DRVEF remained as an independent predictor for cardiac death (P < 0.0001) and major adverse cardiovascular event (P < 0.0001) even in a stepwise multivariable Cox proportional hazard analysis. Classification and regression-tree analysis demonstrated that 3DRVEF played an important role for risk stratification.
Conclusions: 3DTTE-determined RV ejection fraction was independently associated with cardiac outcomes in patients with diverse backgrounds. 3DRVEF offered incremental value over clinical risk factors and the other echocardiographic parameters including left ventricular systolic and diastolic function for predicting future adverse outcome.
Publication titleCirculation: Cardiovascular Imaging
Department/SchoolMenzies Institute for Medical Research
PublisherLippincott Williams & Wilkins
Place of publicationUnited States
Rights statementCopyright 2017 American Heart Association, Inc.