Right ventricular systolic dysfunction is common in hypertensive heart failure: a prospective study in Sub-Saharan Africa

Ojji, Dike B., Lecour, Sandrine, Atherton, John J., Blauwet, Lori A., Alfa, Jacob and Sliwa, Karen (2016) Right ventricular systolic dysfunction is common in hypertensive heart failure: a prospective study in Sub-Saharan Africa. PLoS ONE, 11 4: . doi:10.1371/journal.pone.0153479


Author Ojji, Dike B.
Lecour, Sandrine
Atherton, John J.
Blauwet, Lori A.
Alfa, Jacob
Sliwa, Karen
Title Right ventricular systolic dysfunction is common in hypertensive heart failure: a prospective study in Sub-Saharan Africa
Journal name PLoS ONE   Check publisher's open access policy
ISSN 1932-6203
Publication date 2016-04-13
Sub-type Article (original research)
DOI 10.1371/journal.pone.0153479
Open Access Status DOI
Volume 11
Issue 4
Total pages 11
Place of publication San Francisco, United States
Publisher Public Library of Science
Collection year 2017
Language eng
Formatted abstract
Introduction
Right ventricular (RV) systolic dysfunction is now recognized widely as a strong and independent predictor of adverse outcomes in patients with heart failure (HF). Reduction of RV systolic function more closely predicts impaired exercise tolerance and poor survival than does left ventricular (LV) systolic function. In spite of this, there is a dearth of data on RV function in hypertensive HF which is the commonest form of HF in sub-Saharan Africa. We therefore conducted a prospective cohort study of hypertensive HF patients presenting to the University of Abuja Teaching Hospital, Abuja, Nigeria over an 8 year period.

Methods
Each subject had transthoracic echocardiography performed on them according to the guidelines of American Society of Echocardiography. RV systolic function was defined as a tricuspid annular plane systolic excursion (TAPSE) <15mm using M-mode echocardiography.

Results
RV systolic dysfunction was identified in 272 (44.5%) of the 611 subjects that were studied. Subjects with TAPSE less than 15mm had worse prognosis compared to those with TAPSE ≥15mm.There was a significant correlation between TAPSE and other adverse prognostic markers including left and right atrial area, LV size, LV mass, LV ejection fraction, restrictive mitral inflow and RV systolic pressure (RVSP). However, LV ejection fraction and right atrial area were the only independent determinants of RV systolic dysfunction.

Conclusions
Hypertensive HF is a major cause of RV systolic dysfunction even in a population with a low prevalence of coronary artery disease, and RV systolic dysfunction is associated with poor prognosis in hypertensive HF. Detailed assessment of RV function should therefore be part of the echocardiography evaluation of patients with hypertensive HF.
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Sub-type: Article (original research)
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