P276Right ventricular outflow tract systolic excursion. A novel echocardiographic parameter of right ventricular function associated with poor survival


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Abstract

Background: Right ventricular (RV) function has important prognostic and therapeutic implications. Assessment of RV function using echocardiography is challenging. The aim of this study was to evaluate a new parameter of RV function, right ventricular outflow tract systolic excursion (RVOT_SE).Methods: RVOT_SE was measured using the parasternal short axis view at the level of the aortic valve and M-Mode echocardiography (Figure). We measured the systolic excursion of the RVOT anterior wall. RVOT_SE was measured in 45 patients (age 63±19y, 26 males) with normal RV function (RV fractional area change (RVFAC)>32% and tricuspid annular plane systolic excursion (TAPSE)>1.5 cm) and 27 patients (age 68±14y, 23 males) with reduced RV function (RVFAC<32% and TAPSE<1.5 cm).Results: RVFAC was 46±6% in the normal RV group and 22±5% in the reduced RV group (p<0.0001). TAPSE was 2.2±0.4 cm in the normal RV group and 1.0±0.2 cm in the Reduced RV group (p<0.0001). RVOT_SE was 9.5±1.4 mm in the normal RV group and 1.6±1.1 mm in the reduced RV group (p<0.0001). An RVOT_SE< 6 mm identified patients with reduced RV function with a 100% sensitivity and 100% specificity. Survival at one year was 60% in patients with RVOT_SE<6 mm and 86% in patients with RVOT_SE>6 mm, p<0.002. The figure below shows RVOT_SE measurements (arrows) in a patient with normal (A) and reduced (B) RV function.Conclusions: RVOT_SE is a novel, simple, and promising parameter for assessing RV function, and it is associated with poor survival. Further study is needed to determine the usefulness of RVOT_SE for echocardiographic assessment of RV function.

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