![]() ![]() Lang RM, Badano LP, Mor-Avi V et al (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Zoghbi WA, Adams D, Bonow RO, Enriquez-Sarano M, Foster E, Grayburn PA, Hahn RT, Han Y, Hung J, Lang RM, Little SH, Shah DJ, Shernan S, Thavendiranathan P, Thomas JD, Weissman NJ (2017) Recommendations for noninvasive evaluation of native valvular regurgitation a report from the American Society of Echocardiography developed in collaboration with the Society for Cardiovascular Magnetic Resonance. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Böhm M, Dickstein K et al (2012) ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Zakeri R, Mohammed SF (2015) Epidemiology of right ventricular dysfunction in heart failure with preserved ejection fraction. Inamdar AA, Inamdar AC (2016) Heart failure: diagnosis, management and utilization. National Center for Health Statistics, Hyattsville, p 2013 Murphy SL, Xu JQ, Kochanek KD (2013) Deaths: final data for 2010. Our study suggests that besides EF, other echocardiographic parameters are helpful to optimize the phenotyping and prognostic stratification of HF. These data are indicative that in patients hospitalized with HF, EF is not a suitable predictor of long-term all-cause mortality, whereas, right ventricular volumetric remodeling and IVCd have a prognostic role in HFpEF as well as LAV in HFrEF. At Kaplan–Meier analysis, no differences of survival between HFrEF and HFpEF were found, however, significantly increased all-cause mortality for higher values of basal-RVd, BUN, and IVCd (log-rank p = 0.0065, 0.0063, 0.0005) in HFpEF, and for COPD and higher LAV (log-rank p = 0.0046, p = 0.033) in HFrEF. Excluding LAV from the model, only COPD remained an independent predictor of all-cause mortality (HR 2.15, p = 0.04) in HFrEF. At multivariate Cox model, right ventricular diameter (RVd), inferior vena cava diameter (IVCd) and blood urea nitrogen (BUN) resulted to be significantly associated with all-cause mortality in HFpEF (HR 2.4, p = 0.04 HR 1.06, p = 0.02 HR 1.02, p = 0.01), whereas, left atrial volume (LAV) was significantly associated with mortality in HFrEF (HR 1.06, p = 0.006). The mean follow-up period was of 25.4 months. Patients with acute HF (75 ± 9.8 years), classified in preserved (≥ 50%) and reduced (< 50%) EF (HFpEF and HFrEF, respectively), were enrolled. The aim of the study was to identify simple echocardiographic predictors of post-discharge all-cause mortality in hospitalized HF patients. This happened because, during pacing of the basal interventricular septum, the trans-septal and consequent LV activation started immediately after pacing however, RV lateral wall activation was postponed by the time interval required for the electrical wave-front to reach the right bundle branch Purkinje fibers located in the distal part of the RV septum.Left ventricular ejection fraction (EF) is helpful to differentiate heart failure (HF) phenotype in clinical practice. In patient 2, UHF-ECG interventricular dyssynchrony decreased during RVSP. In patient 1, the interventricular dyssynchrony increased due to the additional trans-septal delay, which was absent during spontaneous rhythm. RVSP resulted in a different set of changes in ventricular synchrony. On the other hand, the patient with a trueLBBB had significant dyssynchrony and the latest activation under lead V8 during spontaneous rhythm. The patient with IVCD presented with minimal interventricular dyssynchrony and the latest activation under V5. Studied patients differed in their UHF-ECG ventricular activation sequence during spontaneous rhythm and RVSP. ![]()
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