The Prevalence and Prognostic Significance of Right Ventricular Systolic Dysfunction in Nonischemic Dilated Cardiomyopathy
BACKGROUND—Cardiovascular magnetic resonance is the gold-standard technique for the assessment of ventricular function. Although left ventricular volumes and ejection fraction are strong predictors of outcome in dilated cardiomyopathy (DCM), there are limited data regarding the prognostic significan...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2013-10, Vol.128 (15), p.1623-1633 |
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| creator | Gulati, Ankur Ismail, Tevfik F. Jabbour, Andrew Alpendurada, Francisco Guha, Kaushik Ismail, Nizar A. Raza, Sadaf Khwaja, Jahanzaib Brown, Tristan D.H. Morarji, Kishen Liodakis, Emmanouil Roughton, Michael Wage, Ricardo Pakrashi, Tapesh C. Sharma, Rakesh Carpenter, John-Paul Cook, Stuart A. Cowie, Martin R. Assomull, Ravi G. Pennell, Dudley J. Prasad, Sanjay K. |
| description | BACKGROUND—Cardiovascular magnetic resonance is the gold-standard technique for the assessment of ventricular function. Although left ventricular volumes and ejection fraction are strong predictors of outcome in dilated cardiomyopathy (DCM), there are limited data regarding the prognostic significance of right ventricular (RV) systolic dysfunction (RVSD). We investigated whether cardiovascular magnetic resonance assessment of RV function has prognostic value in DCM.
METHODS AND RESULTS—We prospectively studied 250 consecutive DCM patients with the use of cardiovascular magnetic resonance. RVSD, defined by RV ejection fraction ≤45%, was present in 86 (34%) patients. During a median follow-up period of 6.8 years, there were 52 deaths, and 7 patients underwent cardiac transplantation. The primary end point of all-cause mortality or cardiac transplantation was reached by 42 of 86 patients with RVSD and 17 of 164 patients without RVSD (49% versus 10%; hazard ratio, 5.90; 95% confidence interval [CI], 3.35–10.37; P |
| doi_str_mv | 10.1161/CIRCULATIONAHA.113.002518 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1443409746</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1443409746</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5188-6e752fea71f603677329090f09fdd7a16697bc52888141469ea243cb38a87d9b3</originalsourceid><addsrcrecordid>eNqNkEtv1DAQgC0EotvCX0DhgMQlxY4dPw4cVuHRlVYtardcI69jbwxOvNgOVfrr8WoXEDdO1sx845n5AHiN4CVCFL1rVrfN_Xq5Wd1cL6-WOYcvIaxqxJ-ABaorUpIai6dgASEUJcNVdQbOY_yWQ4pZ_RycVVjQmnC-AI-bXhdfgv4pnR6VLuTY5dDvRh-TVcWd3Y3WWCUPNW-KW7vrU_FVjylYNTkZirs5Ju8y-mGOZhpVsn4s7Fhc-9FG1evhULJOJt0VjQyd9cPs9zL18wvwzEgX9cvTewHuP33cNFfl-ubzqlmuS5Uv4iXVrK6MlgwZCjFl-R4BBTRQmK5jElEq2FbVFeccEUSo0LIiWG0xl5x1YosvwNvjv_vgf0w6pnbIm2nn5Kj9FFtECCZQMEIzKo6oCj7GoE27D3aQYW4RbA_q23_V5xxuj-pz76vTmGk76O5P52_XGXhzAmRU0pmQpdr4l2McIcJZ5t4fuQfvkg7xu5sedGh7LV3q_2ORX_fuook</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1443409746</pqid></control><display><type>article</type><title>The Prevalence and Prognostic Significance of Right Ventricular Systolic Dysfunction in Nonischemic Dilated Cardiomyopathy</title><source>MEDLINE</source><source>American Heart Association Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Journals@Ovid Complete</source><creator>Gulati, Ankur ; Ismail, Tevfik F. ; Jabbour, Andrew ; Alpendurada, Francisco ; Guha, Kaushik ; Ismail, Nizar A. ; Raza, Sadaf ; Khwaja, Jahanzaib ; Brown, Tristan D.H. ; Morarji, Kishen ; Liodakis, Emmanouil ; Roughton, Michael ; Wage, Ricardo ; Pakrashi, Tapesh C. ; Sharma, Rakesh ; Carpenter, John-Paul ; Cook, Stuart A. ; Cowie, Martin R. ; Assomull, Ravi G. ; Pennell, Dudley J. ; Prasad, Sanjay K.</creator><creatorcontrib>Gulati, Ankur ; Ismail, Tevfik F. ; Jabbour, Andrew ; Alpendurada, Francisco ; Guha, Kaushik ; Ismail, Nizar A. ; Raza, Sadaf ; Khwaja, Jahanzaib ; Brown, Tristan D.H. ; Morarji, Kishen ; Liodakis, Emmanouil ; Roughton, Michael ; Wage, Ricardo ; Pakrashi, Tapesh C. ; Sharma, Rakesh ; Carpenter, John-Paul ; Cook, Stuart A. ; Cowie, Martin R. ; Assomull, Ravi G. ; Pennell, Dudley J. ; Prasad, Sanjay K.</creatorcontrib><description>BACKGROUND—Cardiovascular magnetic resonance is the gold-standard technique for the assessment of ventricular function. Although left ventricular volumes and ejection fraction are strong predictors of outcome in dilated cardiomyopathy (DCM), there are limited data regarding the prognostic significance of right ventricular (RV) systolic dysfunction (RVSD). We investigated whether cardiovascular magnetic resonance assessment of RV function has prognostic value in DCM.
METHODS AND RESULTS—We prospectively studied 250 consecutive DCM patients with the use of cardiovascular magnetic resonance. RVSD, defined by RV ejection fraction ≤45%, was present in 86 (34%) patients. During a median follow-up period of 6.8 years, there were 52 deaths, and 7 patients underwent cardiac transplantation. The primary end point of all-cause mortality or cardiac transplantation was reached by 42 of 86 patients with RVSD and 17 of 164 patients without RVSD (49% versus 10%; hazard ratio, 5.90; 95% confidence interval [CI], 3.35–10.37; P<0.001). On multivariable analysis, RVSD remained a significant independent predictor of the primary end point (hazard ratio, 3.90; 95% CI, 2.16–7.04; P<0.001), as well as secondary outcomes of cardiovascular mortality or cardiac transplantation (hazard ratio, 3.35; 95% CI, 1.76–6.39; P<0.001), and heart failure death, heart failure hospitalization, or cardiac transplantation (hazard ratio, 2.70; 95% CI, 1.32–5.51; P=0.006). Assessment of RVSD improved risk stratification for all-cause mortality or cardiac transplantation (net reclassification improvement, 0.31; 95% CI 0.10–0.53; P=0.001).
CONCLUSIONS—RVSD is a powerful, independent predictor of transplant-free survival and adverse heart failure outcomes in DCM. Cardiovascular magnetic resonance assessment of RV function is important in the evaluation and risk stratification of DCM patients.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.113.002518</identifier><identifier>PMID: 23965488</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: by the American College of Cardiology Foundation and the American Heart Association, Inc</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Cardiomyopathy, Dilated - mortality ; Cardiomyopathy, Dilated - pathology ; Cardiomyopathy, Dilated - physiopathology ; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous ; Female ; Follow-Up Studies ; Heart ; Heart failure, cardiogenic pulmonary edema, cardiac enlargement ; Humans ; Kaplan-Meier Estimate ; Magnetic Resonance Imaging ; Male ; Medical sciences ; Middle Aged ; Myocarditis. Cardiomyopathies ; Predictive Value of Tests ; Prevalence ; Prognosis ; Prospective Studies ; Risk Factors ; Stroke Volume - physiology ; Ventricular Dysfunction, Right - mortality ; Ventricular Dysfunction, Right - pathology ; Ventricular Dysfunction, Right - physiopathology ; Ventricular Function, Right - physiology</subject><ispartof>Circulation (New York, N.Y.), 2013-10, Vol.128 (15), p.1623-1633</ispartof><rights>2013 by the American College of Cardiology Foundation and the American Heart Association, Inc.</rights><rights>2014 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5188-6e752fea71f603677329090f09fdd7a16697bc52888141469ea243cb38a87d9b3</citedby><cites>FETCH-LOGICAL-c5188-6e752fea71f603677329090f09fdd7a16697bc52888141469ea243cb38a87d9b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27811487$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23965488$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gulati, Ankur</creatorcontrib><creatorcontrib>Ismail, Tevfik F.</creatorcontrib><creatorcontrib>Jabbour, Andrew</creatorcontrib><creatorcontrib>Alpendurada, Francisco</creatorcontrib><creatorcontrib>Guha, Kaushik</creatorcontrib><creatorcontrib>Ismail, Nizar A.</creatorcontrib><creatorcontrib>Raza, Sadaf</creatorcontrib><creatorcontrib>Khwaja, Jahanzaib</creatorcontrib><creatorcontrib>Brown, Tristan D.H.</creatorcontrib><creatorcontrib>Morarji, Kishen</creatorcontrib><creatorcontrib>Liodakis, Emmanouil</creatorcontrib><creatorcontrib>Roughton, Michael</creatorcontrib><creatorcontrib>Wage, Ricardo</creatorcontrib><creatorcontrib>Pakrashi, Tapesh C.</creatorcontrib><creatorcontrib>Sharma, Rakesh</creatorcontrib><creatorcontrib>Carpenter, John-Paul</creatorcontrib><creatorcontrib>Cook, Stuart A.</creatorcontrib><creatorcontrib>Cowie, Martin R.</creatorcontrib><creatorcontrib>Assomull, Ravi G.</creatorcontrib><creatorcontrib>Pennell, Dudley J.</creatorcontrib><creatorcontrib>Prasad, Sanjay K.</creatorcontrib><title>The Prevalence and Prognostic Significance of Right Ventricular Systolic Dysfunction in Nonischemic Dilated Cardiomyopathy</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>BACKGROUND—Cardiovascular magnetic resonance is the gold-standard technique for the assessment of ventricular function. Although left ventricular volumes and ejection fraction are strong predictors of outcome in dilated cardiomyopathy (DCM), there are limited data regarding the prognostic significance of right ventricular (RV) systolic dysfunction (RVSD). We investigated whether cardiovascular magnetic resonance assessment of RV function has prognostic value in DCM.
METHODS AND RESULTS—We prospectively studied 250 consecutive DCM patients with the use of cardiovascular magnetic resonance. RVSD, defined by RV ejection fraction ≤45%, was present in 86 (34%) patients. During a median follow-up period of 6.8 years, there were 52 deaths, and 7 patients underwent cardiac transplantation. The primary end point of all-cause mortality or cardiac transplantation was reached by 42 of 86 patients with RVSD and 17 of 164 patients without RVSD (49% versus 10%; hazard ratio, 5.90; 95% confidence interval [CI], 3.35–10.37; P<0.001). On multivariable analysis, RVSD remained a significant independent predictor of the primary end point (hazard ratio, 3.90; 95% CI, 2.16–7.04; P<0.001), as well as secondary outcomes of cardiovascular mortality or cardiac transplantation (hazard ratio, 3.35; 95% CI, 1.76–6.39; P<0.001), and heart failure death, heart failure hospitalization, or cardiac transplantation (hazard ratio, 2.70; 95% CI, 1.32–5.51; P=0.006). Assessment of RVSD improved risk stratification for all-cause mortality or cardiac transplantation (net reclassification improvement, 0.31; 95% CI 0.10–0.53; P=0.001).
CONCLUSIONS—RVSD is a powerful, independent predictor of transplant-free survival and adverse heart failure outcomes in DCM. Cardiovascular magnetic resonance assessment of RV function is important in the evaluation and risk stratification of DCM patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Cardiomyopathy, Dilated - mortality</subject><subject>Cardiomyopathy, Dilated - pathology</subject><subject>Cardiomyopathy, Dilated - physiopathology</subject><subject>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocarditis. Cardiomyopathies</subject><subject>Predictive Value of Tests</subject><subject>Prevalence</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Stroke Volume - physiology</subject><subject>Ventricular Dysfunction, Right - mortality</subject><subject>Ventricular Dysfunction, Right - pathology</subject><subject>Ventricular Dysfunction, Right - physiopathology</subject><subject>Ventricular Function, Right - physiology</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkEtv1DAQgC0EotvCX0DhgMQlxY4dPw4cVuHRlVYtardcI69jbwxOvNgOVfrr8WoXEDdO1sx845n5AHiN4CVCFL1rVrfN_Xq5Wd1cL6-WOYcvIaxqxJ-ABaorUpIai6dgASEUJcNVdQbOY_yWQ4pZ_RycVVjQmnC-AI-bXhdfgv4pnR6VLuTY5dDvRh-TVcWd3Y3WWCUPNW-KW7vrU_FVjylYNTkZirs5Ju8y-mGOZhpVsn4s7Fhc-9FG1evhULJOJt0VjQyd9cPs9zL18wvwzEgX9cvTewHuP33cNFfl-ubzqlmuS5Uv4iXVrK6MlgwZCjFl-R4BBTRQmK5jElEq2FbVFeccEUSo0LIiWG0xl5x1YosvwNvjv_vgf0w6pnbIm2nn5Kj9FFtECCZQMEIzKo6oCj7GoE27D3aQYW4RbA_q23_V5xxuj-pz76vTmGk76O5P52_XGXhzAmRU0pmQpdr4l2McIcJZ5t4fuQfvkg7xu5sedGh7LV3q_2ORX_fuook</recordid><startdate>20131008</startdate><enddate>20131008</enddate><creator>Gulati, Ankur</creator><creator>Ismail, Tevfik F.</creator><creator>Jabbour, Andrew</creator><creator>Alpendurada, Francisco</creator><creator>Guha, Kaushik</creator><creator>Ismail, Nizar A.</creator><creator>Raza, Sadaf</creator><creator>Khwaja, Jahanzaib</creator><creator>Brown, Tristan D.H.</creator><creator>Morarji, Kishen</creator><creator>Liodakis, Emmanouil</creator><creator>Roughton, Michael</creator><creator>Wage, Ricardo</creator><creator>Pakrashi, Tapesh C.</creator><creator>Sharma, Rakesh</creator><creator>Carpenter, John-Paul</creator><creator>Cook, Stuart A.</creator><creator>Cowie, Martin R.</creator><creator>Assomull, Ravi G.</creator><creator>Pennell, Dudley J.</creator><creator>Prasad, Sanjay K.</creator><general>by the American College of Cardiology Foundation and the American Heart Association, Inc</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20131008</creationdate><title>The Prevalence and Prognostic Significance of Right Ventricular Systolic Dysfunction in Nonischemic Dilated Cardiomyopathy</title><author>Gulati, Ankur ; Ismail, Tevfik F. ; Jabbour, Andrew ; Alpendurada, Francisco ; Guha, Kaushik ; Ismail, Nizar A. ; Raza, Sadaf ; Khwaja, Jahanzaib ; Brown, Tristan D.H. ; Morarji, Kishen ; Liodakis, Emmanouil ; Roughton, Michael ; Wage, Ricardo ; Pakrashi, Tapesh C. ; Sharma, Rakesh ; Carpenter, John-Paul ; Cook, Stuart A. ; Cowie, Martin R. ; Assomull, Ravi G. ; Pennell, Dudley J. ; Prasad, Sanjay K.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5188-6e752fea71f603677329090f09fdd7a16697bc52888141469ea243cb38a87d9b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Cardiomyopathy, Dilated - mortality</topic><topic>Cardiomyopathy, Dilated - pathology</topic><topic>Cardiomyopathy, Dilated - physiopathology</topic><topic>Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Heart failure, cardiogenic pulmonary edema, cardiac enlargement</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocarditis. Cardiomyopathies</topic><topic>Predictive Value of Tests</topic><topic>Prevalence</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Stroke Volume - physiology</topic><topic>Ventricular Dysfunction, Right - mortality</topic><topic>Ventricular Dysfunction, Right - pathology</topic><topic>Ventricular Dysfunction, Right - physiopathology</topic><topic>Ventricular Function, Right - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gulati, Ankur</creatorcontrib><creatorcontrib>Ismail, Tevfik F.</creatorcontrib><creatorcontrib>Jabbour, Andrew</creatorcontrib><creatorcontrib>Alpendurada, Francisco</creatorcontrib><creatorcontrib>Guha, Kaushik</creatorcontrib><creatorcontrib>Ismail, Nizar A.</creatorcontrib><creatorcontrib>Raza, Sadaf</creatorcontrib><creatorcontrib>Khwaja, Jahanzaib</creatorcontrib><creatorcontrib>Brown, Tristan D.H.</creatorcontrib><creatorcontrib>Morarji, Kishen</creatorcontrib><creatorcontrib>Liodakis, Emmanouil</creatorcontrib><creatorcontrib>Roughton, Michael</creatorcontrib><creatorcontrib>Wage, Ricardo</creatorcontrib><creatorcontrib>Pakrashi, Tapesh C.</creatorcontrib><creatorcontrib>Sharma, Rakesh</creatorcontrib><creatorcontrib>Carpenter, John-Paul</creatorcontrib><creatorcontrib>Cook, Stuart A.</creatorcontrib><creatorcontrib>Cowie, Martin R.</creatorcontrib><creatorcontrib>Assomull, Ravi G.</creatorcontrib><creatorcontrib>Pennell, Dudley J.</creatorcontrib><creatorcontrib>Prasad, Sanjay K.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gulati, Ankur</au><au>Ismail, Tevfik F.</au><au>Jabbour, Andrew</au><au>Alpendurada, Francisco</au><au>Guha, Kaushik</au><au>Ismail, Nizar A.</au><au>Raza, Sadaf</au><au>Khwaja, Jahanzaib</au><au>Brown, Tristan D.H.</au><au>Morarji, Kishen</au><au>Liodakis, Emmanouil</au><au>Roughton, Michael</au><au>Wage, Ricardo</au><au>Pakrashi, Tapesh C.</au><au>Sharma, Rakesh</au><au>Carpenter, John-Paul</au><au>Cook, Stuart A.</au><au>Cowie, Martin R.</au><au>Assomull, Ravi G.</au><au>Pennell, Dudley J.</au><au>Prasad, Sanjay K.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Prevalence and Prognostic Significance of Right Ventricular Systolic Dysfunction in Nonischemic Dilated Cardiomyopathy</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2013-10-08</date><risdate>2013</risdate><volume>128</volume><issue>15</issue><spage>1623</spage><epage>1633</epage><pages>1623-1633</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>BACKGROUND—Cardiovascular magnetic resonance is the gold-standard technique for the assessment of ventricular function. Although left ventricular volumes and ejection fraction are strong predictors of outcome in dilated cardiomyopathy (DCM), there are limited data regarding the prognostic significance of right ventricular (RV) systolic dysfunction (RVSD). We investigated whether cardiovascular magnetic resonance assessment of RV function has prognostic value in DCM.
METHODS AND RESULTS—We prospectively studied 250 consecutive DCM patients with the use of cardiovascular magnetic resonance. RVSD, defined by RV ejection fraction ≤45%, was present in 86 (34%) patients. During a median follow-up period of 6.8 years, there were 52 deaths, and 7 patients underwent cardiac transplantation. The primary end point of all-cause mortality or cardiac transplantation was reached by 42 of 86 patients with RVSD and 17 of 164 patients without RVSD (49% versus 10%; hazard ratio, 5.90; 95% confidence interval [CI], 3.35–10.37; P<0.001). On multivariable analysis, RVSD remained a significant independent predictor of the primary end point (hazard ratio, 3.90; 95% CI, 2.16–7.04; P<0.001), as well as secondary outcomes of cardiovascular mortality or cardiac transplantation (hazard ratio, 3.35; 95% CI, 1.76–6.39; P<0.001), and heart failure death, heart failure hospitalization, or cardiac transplantation (hazard ratio, 2.70; 95% CI, 1.32–5.51; P=0.006). Assessment of RVSD improved risk stratification for all-cause mortality or cardiac transplantation (net reclassification improvement, 0.31; 95% CI 0.10–0.53; P=0.001).
CONCLUSIONS—RVSD is a powerful, independent predictor of transplant-free survival and adverse heart failure outcomes in DCM. Cardiovascular magnetic resonance assessment of RV function is important in the evaluation and risk stratification of DCM patients.</abstract><cop>Hagerstown, MD</cop><pub>by the American College of Cardiology Foundation and the American Heart Association, Inc</pub><pmid>23965488</pmid><doi>10.1161/CIRCULATIONAHA.113.002518</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation (New York, N.Y.), 2013-10, Vol.128 (15), p.1623-1633 |
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| subjects | Adult Aged Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Cardiomyopathy, Dilated - mortality Cardiomyopathy, Dilated - pathology Cardiomyopathy, Dilated - physiopathology Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous Female Follow-Up Studies Heart Heart failure, cardiogenic pulmonary edema, cardiac enlargement Humans Kaplan-Meier Estimate Magnetic Resonance Imaging Male Medical sciences Middle Aged Myocarditis. Cardiomyopathies Predictive Value of Tests Prevalence Prognosis Prospective Studies Risk Factors Stroke Volume - physiology Ventricular Dysfunction, Right - mortality Ventricular Dysfunction, Right - pathology Ventricular Dysfunction, Right - physiopathology Ventricular Function, Right - physiology |
| title | The Prevalence and Prognostic Significance of Right Ventricular Systolic Dysfunction in Nonischemic Dilated Cardiomyopathy |
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