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Heart failure is a cardiovascular disease that is caused by impaired left ventricular systolic and diastolic function. Ischemic and non-ischemic cardiomyopathies are the most common cause of heart failure. Its mortality is high despite to the new treatment regimens. Along with dilatation left ventricul, right ventricular changes, particularly structural and functional, occurs in the advanced heart failure. Assessment of the right ventricular function is very important as it has prognostic significance in mortality and morbidity. Although right ventricle is often neglected due to complexity in the assessment of function and structure, provides valuable information on the current practice. Impaired parameters used in the assessment of right ventricular systolic and diastolic function are different in ischemic and non-ischemic cardiomyopathy depending on the underlying cause. In the present study, we aimed to investigate right ventricular volume, diameter and systolic function in ischemic and non-ischemic cardiomyopathy by 2D, M mode, transvalvular Doppler and tissue Doppler echocardiography.
The study population consisted of 20 ischemic (ICMP) and 21 non-ischemic dilated cardiomyopathy (NICMP) patients with reduced left ventricular function (EF <%35), increased left ventricular end-diastolic diameter (LVEDD >5.5 cm), sinus ritm, less than moderate valve disease. The volume, diameter and functions of the right and left ventricle are assessed by echocardiography. According to ischemic and non-ischemic cardiomyopathy groups, right ventricular structure and function were compared by using correlation analysis.
Patients left ventricular systolic and diastolic functions evaluated by 2D, mitral flow Doppler and tissue Doppler echocardiography were similar in both groups. Right ventricular longitudinal diameter in ischemic CMP was significantly lower when compared with non-ischemic CMP (7.56 cm, 6.66 cm p=0.001). Mean RVEF was comparable between the groups and 59% in NICMP while 61% in ICMP (p=0,346). There were no significant differences between the groups regarding right ventricular tricuspid flow Doppler parameters. In tissue Doppler parameters, RV lateral annulus Sm velocity was significantly lower in ICMP than NICMP (0.11 cm/sn vs 0.09 cm/sn; p=0.007). TAPSE values was significantly lover in the ICMP group (2.29 and 2.02 p=0.024).The other parameters assessed by tissue Doppler echocardiography were comparable between the groups.
Reduction in right ventricular function might be different due to hemodynamic deterioration, right ventricular infarction and also involvement of right ventricular myopathic changes. The present study results revealed that right ventricular function was significantly decreased in ischemic heart failure when compared to the non-ischemic group.