Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jan 19;121(2):252-8.
doi: 10.1161/CIRCULATIONAHA.109.887570. Epub 2010 Jan 4.

Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure

Philippe Meyer  1 , Gerasimos S Filippatos, Mustafa I Ahmed, Ami E Iskandrian, Vera Bittner, Gilbert J Perry, Michel White, Inmaculada B Aban, Marjan Mujib, Louis J Dell'Italia, Ali Ahmed
Affiliations

Effects of right ventricular ejection fraction on outcomes in chronic systolic heart failure

Philippe Meyer et al. Circulation. .

Abstract

Background: Studies of the effect of right ventricular ejection fraction (RVEF) on outcomes in heart failure (HF) are limited by small sample size and short follow-up.

Methods and results: We examined the effect of baseline RVEF on outcomes in 2008 Beta-Blocker Evaluation of Survival Trial (BEST) participants with HF and left ventricular ejection fraction <or=35% during 24 months of mean follow-up. RVEF, estimated by gated-equilibrium radionuclide ventriculography, was used to categorize patients into 4 RVEF groups: >or=40% (n=733), 30% to 39% (n=531), 20% to 29% (n=473), and <20% (n=271). Unadjusted rates for all-cause mortality in patients with RVEF >or=40%, 30% to 39%, 20% to 29%, and <20% were 27%, 32%, 35%, and 47%, respectively. When compared with patients with RVEF >or=40%, unadjusted hazard ratios and 95% confidence intervals for all-cause mortality for those with RVEF 30% to 39%, 20% to 29%, and <20% were 1.19 (0.97 to 1.46; P=0.087), 1.45 (1.17 to 1.78; P=0.001), and 1.98 (1.59 to 2.47; P<0.0001), respectively. Respective multivariable-adjusted hazard ratios (95% confidence intervals) for all-cause mortality associated with RVEF 30% to 39%, 20% to 29%, and <20% were 1.07 (0.87 to 1.32; P=0.518), 1.12 (0.89 to 1.40; P=0.328), and 1.32 (1.02 to 1.71; P=0.034), respectively. Adjusted hazard ratios (95% confidence intervals) for other outcomes associated with RVEF <20% (compared with >or=40%) were as follows: cardiovascular mortality, 1.33 (1.01 to 1.76; P=0.041); HF mortality, 1.61 (1.03 to 2.52; P=0.037); sudden cardiac death, 1.29 (0.87 to 1.91; P=0.212); all-cause hospitalization, 1.21 (1.00 to 1.47; P=0.056); and HF hospitalization, 1.39 (1.10 to 1.77; P=0.007).

Conclusions: Baseline RVEF <20% is a significant independent predictor of mortality and HF hospitalization in systolic HF.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: None

Figures

Figure 1
Figure 1
Histogram displaying frequency distribution of right ventricular ejection fraction (%)
Figure 2
Figure 2
Kaplan-Meier plots for (2a) all-cause mortality and (2b) heart failure hospitalization by right ventricular ejection fraction (RVEF) categories
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Hunt SA, Abraham WT, Chin MH, Feldman AM, Francis GS, Ganiats TG, Jessup M, Konstam MA, Mancini DM, Michl K, Oates JA, Rahko PS, Silver MA, Stevenson LW, Yancy CW. 2009 focused update incorporated into the ACC/AHA 2005 Guidelines for the Diagnosis and Management of Heart Failure in Adults: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the International Society for Heart and Lung Transplantation. Circulation. 2009;119:e391–479. - PubMed
    1. Ahmed A, Perry GJ, Fleg JL, Love TE, Goff DC, Jr, Kitzman DW. Outcomes in ambulatory chronic systolic and diastolic heart failure: a propensity score analysis. Am Heart J. 2006;152:956–966. - PMC - PubMed
    1. Martinez-Selles M, Garcia Robles JA, Prieto L, Dominguez Munoa M, Frades E, Diaz-Castro O, Almendral J. Systolic dysfunction is a predictor of long term mortality in men but not in women with heart failure. Eur Heart J. 2003;24:2046–2053. - PubMed
    1. Dickstein K, Cohen-Solal A, Filippatos G, McMurray JJ, Ponikowski P, Poole-Wilson PA, Stromberg A, van Veldhuisen DJ, Atar D, Hoes AW, Keren A, Mebazaa A, Nieminen M, Priori SG, Swedberg K, Vahanian A, Camm J, De Caterina R, Dean V, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM) Eur Heart J. 2008;29:2388–2442. - PubMed
    1. Haddad F, Hunt SA, Rosenthal DN, Murphy DJ. Right Ventricular Function in Cardiovascular Disease, Part I: Anatomy, Physiology, Aging, and Functional Assessment of the Right Ventricle. Circulation. 2008;117:1436–1448. - PubMed

Publication types