Pulmonary vascular disease & thromboembolismCohort study
Aetiology and outcomes of severe right ventricular dysfunction
- Retrospective cohort study
- single-centre
- consecutive patients
Authors' conclusion
One-year mortality of patients with severe RVD was high (∼40%) and dependent on the aetiology of RVD. Left-sided heart diseases is the most common cause of severe RVD but prognosis was worst in CLD.
Study context
- Population
- Patients with severe right ventricular dysfunction (RVD) on TTE, 2011–2015, single tertiary referral institution; prior cardiac surgery, mechanical assist devices and congenital heart disease excludedof 64,728 undergoing TTE
- Participants
- 1,299 patients
- Exposure
- Survival by aetiology of severe RVD
- Outcome
- All-cause mortality
Main finding
As reported in the abstract
Survival · 1 and 5 years
| Group | 1-year survival | 5-year survival |
|---|---|---|
| Left-sided heart diseases | 61% (95% CI 57-65%) | 33% (95% CI 28-37%) |
| Pulmonary arterial hypertension (PAH) | 76% (95% CI 68-82%) | 50% (95% CI 40-59%) |
| Thromboembolic diseases | 71% (95% CI 64-76%) | 49% (95% CI 41-58%) |
| Chronic lung disease/hypoxia (CLD) | 42% (95% CI 35-49%) | 8% (95% CI 4-15%) |
- Across aetiologies: P < 0.0001
- Overall 1-year survival
- 61% [95% CI 58-64%]
- Overall 5-year survival
- 35% (95% CI 31-38%)
- Deaths during 2 ± 2 years follow-up
- 701
- Deaths within first year of diagnosis
- 66%
Observational data: associations, not effects.
Further findings
Causes of severe RVD
Prevalence of ≥mild RVD among TTE patients
- ≥mild RVD
- 21%
≥moderate tricuspid regurgitation
- ≥moderate tricuspid regurgitation portended worse survival in severe RVD
Original publication
Aetiology and outcomes of severe right ventricular dysfunction. Eur Heart J. Published 11 February 2020. doi:10.1093/eurheartj/ehaa037
Summarised from the published abstract; every number is checked against it