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. 2024 Jul 31:17:100535.
doi: 10.1016/j.ijcchd.2024.100535. eCollection 2024 Sep.

Subpulmonary ventricular function and inflammation are related to clinical heart failure in patients with a systemic right ventricle

Valérie Spalart  1   2 , Aleksandra Cieplucha  3   4   5 , Werner Budts  3   4 , Pieter De Meester  3 , Els Troost  3   4 , Thilo Witsch  6   7 , Walter Droogne  2 , Lucas Nl Van Aelst  2   4 , Magalie Ladouceur  8   9 , Kimberly Martinod  1 , Alexander Van De Bruaene  3   4
Affiliations

Subpulmonary ventricular function and inflammation are related to clinical heart failure in patients with a systemic right ventricle

Valérie Spalart et al. Int J Cardiol Congenit Heart Dis. .

Abstract

Background: Timely diagnosis of heart failure (HF) in patients with a systemic right ventricle (sRV) is difficult but important since clinical deterioration is fast once HF develops. We aimed to compare echocardiography and biomarker profile between sRV patients with and without HF and patients with a systemic left ventricle diagnosed with HF (sLV-HF).

Methods and results: Eighty-seven sRV patients and 30 sLV-HF patients underwent echocardiographic evaluation and blood sampling. Compared to sRV patients without HF, sRV-HF patients had more remodeling of the subpulmonary LV (spLV) (internal diameter 3.9 cm [3.3-5.7] vs 3.4 cm [2.9-3.9], P = 0.03, posterior wall 0.93 cm [0.76-1.20] vs 0.71 cm [0.59-0.91], P = 0.006) and lower spLV systolic function: ejection fraction (59 % ± 14 vs 70 % ± 10, P = 0.011), mitral annular plane systolic excursion (1.7 cm ± 0.5 vs 2.1 cm ± 0.4, P = 0.003), fractional area change (47 % [38-58] vs 59 % [51-70], P = 0.002) and lateral strain rate (-1.2/s ± 0.46 vs -1.5/s ± 0.39, P = 0.016). Inflammatory biomarkers were higher in sRV-HF patients compared to those without HF: red cell distribution width (13.3 fL [12.8-14.1] vs 12.6 fL [12.3-13.1], P < 0.001), neutrophil lymphocyte ratio (NLR, 3.7 [2.2-4.9] vs 2.4 [1.9-3.0], P = 0.015), C-reactive protein (CRP, 2.5 mg/dL [1.0-4.2] vs 1.2 mg/dL [0.0-2.0], P = 0.005) and compared to sLV-HF patients (NLR (3.7 [2.2-4.9] vs 2.5 [1.7-3.3], P = 0.044) and CRP (2.5 mg/dL [1.0-4.2] vs 0.85 mg/dL [0.6-2.0], P = 0.006).

Conclusion: Biventricular echocardiographic evaluation with a focus on the subpulmonary LV together with assessing inflammatory status in sRV patients could help in an earlier detection of HF.

Keywords: Echocardiography; Heart failure; Inflammation; Subpulmonary left ventricle; Systemic left ventricle; Systemic right ventricle.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper; two of the authors (WB, ML) serve as EB Members of the IJCCHD, but have not been involved with the handling of this paper.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Heatmap showing Spearman correlation analysis between echocardiographic measurements and biomarkers for each group separately.
Fig. 2
Fig. 2
Univariate linear regression between NT-proBNP and systolic function of the subpulmonary and systemic ventricle in the 3 groups.
See this image and copyright information in PMC

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