PhD Scientific Days 2023

Clinical Medicine - Posters A

Discordance Between Conventional Functional Parameters and 3D Echocardiography-derived Ejection Fraction in the Detection of Right Ventricular Systolic Dysfunction

Előadó neve

Tolvaj, Máté

Neptun code

B0HDYY

Előadó munkahelye

Heart and Vascular Center, Semmelweis University, Budapest

Előadó telefonszáma

06307386810

Előadó e-mail címe

tolvajmate@gmail.com

Az előadás címe

Discordance Between Conventional Functional Parameters and 3D Echocardiography-derived Ejection Fraction in the Detection of Right Ventricular Systolic Dysfunction

Szerző(k) neve és munkahelye

Máté Tolvaj1, Noela Radu2,3, Andrea Cascella4, Denisa Muraru2,4, Bálint Lakatos1, Alexandra Fábián1, Márton Tokodi1, Michele Tomaselli2,4, Mara Gavazzoni2,4, Francesco Perelli4, Béla Merkely1, Luigi P. Badano2,4, Attila Kovács1, Elena Surkova5,6

1Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
3Carol Davila University of Medicine and Pharmacy, Prof. Dr. C. C. Iliescu Institute, Bucharest, Romania
4Department of Cardiology, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy
5Royal Brompton and Harefield Hospitals, Part of Guy’s and St Thomas’ NHS Foundation
Trust, London, UK
6National Heart and Lung Institute, Imperial College London, London, UK

Bemutatás módja

Poszter

Szekció

Clinical Medicine - Posters A

Language of the presentation

English

Preferred session

Clinical Medicine

Összefoglaló szövege

The conventional echocardiographic parameters of the right ventricular (RV) systolic function (e.g., tricuspid annular plane systolic excursion - TAPSE, fractional area change - FAC) only partially portray the complex functional characteristics of the RV; therefore, they may fail to capture the full spectrum of RV dysfunction and associated adverse clinical outcomes. 3D echocardiography-derived RV ejection fraction (RVEF) is a well-validated and reproducible parameter that overcomes these limitations.

We aimed to investigate the discordance between TAPSE, FAC and RVEF in RV systolic function grading and associated outcomes.

Two retrospective databases from different centers including consecutive patients with various cardiac diseases who underwent clinically indicated 2D and 3D echocardiography (n=750) were analysed. Patients were followed up for the occurrence of all-cause mortality. RVEF was measured by a single, commercially available 3D software package. Guideline-recommended cut-off values were used to indicate RV systolic dysfunction (TAPSE<17 mm, FAC<35%). RVEF <45% served as the “ground truth” of RV dysfunction.

Among patients with normal RVEF (n=511), 109 (21%) had reduced TAPSE, 168 (33%) had reduced FAC, and 49 (10%) had both reduced TAPSE and FAC. Among patients with reduced RVEF (n=239), 108 (45%) had normal TAPSE, 57 (24%) had normal FAC, and 38 (16%) had both normal TAPSE and FAC. Correspondingly, sensitivity and specificity for discrimination of RV systolic dysfunction (RVEF<45%) were 66% and 70% for TAPSE, and 71% and 76% for FAC on ROC analysis, respectively.
During the median follow-up time of 3.7 years, 112 patients (15%) died. Using univariable Cox regression, TAPSE (HR [95% CI]: 0.911 [0.881 - 0.942]), FAC (0.940 [0.924 - 0.957]), and RVEF (0.928 [0.913 - 0.944]) were all significant predictors of mortality (p<0.001). Interestingly, combination of the functional assessments based on either TAPSE or FAC with RVEF separates four risk groups that differ significantly in terms of all-cause mortality (log-rank p<0.05).

Guideline-recommended cut-off values of conventional echocardiographic parameters of RV systolic function are only modestly associated with RVEF-based assessment. This phenomenon may hinder the proper risk stratification of patients with RV systolic dysfunction.

Supported by the EFOP-3.6.3-VEKOP-16-2017-00009 project.

University and Doctoral School

Semmelweis University, Doctoral School of Theoretical and Translational Medicine

Supervisor

Attila Kovács MD Ph.D.

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

Kind

Szabad

Status

elfogadva

Accepted presentation method

poszter

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

6814

Start

11:06

End

11:11

Authors (legacy)

Máté Tolvaj1, Noela Radu2,3, Andrea Cascella4, Denisa Muraru2,4, Bálint Lakatos1, Alexandra Fábián1, Márton Tokodi1, Michele Tomaselli2,4, Mara Gavazzoni2,4, Francesco Perelli4, Béla Merkely1, Luigi P. Badano2,4, Attila Kovács1, Elena Surkova5,6

1Heart and Vascular Center, Semmelweis University, Budapest, Hungary
2Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
3Carol Davila University of Medicine and Pharmacy, Prof. Dr. C. C. Iliescu Institute, Bucharest, Romania
4Department of Cardiology, Istituto Auxologico Italiano, IRCCS, San Luca Hospital, Milan, Italy
5Royal Brompton and Harefield Hospitals, Part of Guy’s and St Thomas’ NHS Foundation
Trust, London, UK
6National Heart and Lung Institute, Imperial College London, London, UK