Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study)

Nagesh S Anavekar; Hicham Skali; Mikhail Bourgoun; Jalal K Ghali; Lars Valeur Køber; Aldo P Maggioni; John J V McMurray; Eric Velazquez; Robert Califf; Marc A Pfeffer; Scott D Solomon

doi:10.1016/j.amjcard.2007.09.115

Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study)

Nagesh S Anavekar, Hicham Skali, Mikhail Bourgoun, Jalal K Ghali, Lars Valeur Køber, Aldo P Maggioni, John J V McMurray, Eric Velazquez, Robert Califf, Marc A Pfeffer, Scott D Solomon

146 Citations (Scopus)

Abstract

Severe right ventricular dysfunction independent of left ventricular ejection fraction increased the risk of heart failure (HF) and death after myocardial infarction (MI). The association between right ventricular function and other clinical outcomes after MI was less clear. Two-dimensional echocardiograms were obtained in 605 patients with left ventricular dysfunction and/or clinical/radiologic evidence of HF from the VALIANT echocardiographic substudy (mean 5.0 +/- 2.5 days after MI). Clinical outcomes included all-cause mortality, cardiovascular (CV) death, sudden death, HF, and stroke. Baseline right ventricular function was measured in 522 patients using right ventricular fractional area change (RVFAC) and was related to clinical outcomes. Mean RVFAC was 41.9 +/- 4.3% (range 19.2% to 53.1%). The incidence of clinical events increased with decreasing RVFAC. After adjusting for 11 covariates, including age, ejection fraction, and Killip's classification, decreased RVFAC was independently associated with increased risk of all-cause mortality (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.31 to 1.98), CV death (HR 1.62, 95% CI 1.30 to 2.01), sudden death (HR 1.79, 95% CI 1.26 to 2.54), HF (HR 1.48, 95% CI 1.17 to 1.86), and stroke (HR 2.95, 95% CI 1.76 to 4.95), but not recurrent MI. Each 5% decrease in baseline RVFAC was associated with a 1.53 (95% CI 1.24 to 1.88) increased risk of fatal and nonfatal CV outcomes. In conclusion, decreased right ventricular systolic function is a major risk factor for death, sudden death, HF, and stroke after MI.

Original language	English
Journal	American Journal of Cardiology
Volume	101
Issue number	5
Pages (from-to)	607-12
Number of pages	5
ISSN	0002-9149
DOIs	https://doi.org/10.1016/j.amjcard.2007.09.115
Publication status	Published - 2008

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10.1016/j.amjcard.2007.09.115

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Anavekar, N. S., Skali, H., Bourgoun, M., Ghali, J. K., Køber, L. V., Maggioni, A. P., McMurray, J. J. V., Velazquez, E., Califf, R., Pfeffer, M. A., & Solomon, S. D. (2008). Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study). American Journal of Cardiology, 101(5), 607-12. https://doi.org/10.1016/j.amjcard.2007.09.115

Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study). / Anavekar, Nagesh S; Skali, Hicham; Bourgoun, Mikhail et al.

In: American Journal of Cardiology, Vol. 101, No. 5, 2008, p. 607-12.

Research output: Contribution to journal › Journal article › Research › peer-review

Anavekar, NS, Skali, H, Bourgoun, M, Ghali, JK, Køber, LV, Maggioni, AP, McMurray, JJV, Velazquez, E, Califf, R, Pfeffer, MA & Solomon, SD 2008, 'Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study)', American Journal of Cardiology, vol. 101, no. 5, pp. 607-12. https://doi.org/10.1016/j.amjcard.2007.09.115

@article{ae1473b0118611df803f000ea68e967b,

title = "Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study)",

abstract = "Severe right ventricular dysfunction independent of left ventricular ejection fraction increased the risk of heart failure (HF) and death after myocardial infarction (MI). The association between right ventricular function and other clinical outcomes after MI was less clear. Two-dimensional echocardiograms were obtained in 605 patients with left ventricular dysfunction and/or clinical/radiologic evidence of HF from the VALIANT echocardiographic substudy (mean 5.0 +/- 2.5 days after MI). Clinical outcomes included all-cause mortality, cardiovascular (CV) death, sudden death, HF, and stroke. Baseline right ventricular function was measured in 522 patients using right ventricular fractional area change (RVFAC) and was related to clinical outcomes. Mean RVFAC was 41.9 +/- 4.3% (range 19.2% to 53.1%). The incidence of clinical events increased with decreasing RVFAC. After adjusting for 11 covariates, including age, ejection fraction, and Killip's classification, decreased RVFAC was independently associated with increased risk of all-cause mortality (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.31 to 1.98), CV death (HR 1.62, 95% CI 1.30 to 2.01), sudden death (HR 1.79, 95% CI 1.26 to 2.54), HF (HR 1.48, 95% CI 1.17 to 1.86), and stroke (HR 2.95, 95% CI 1.76 to 4.95), but not recurrent MI. Each 5% decrease in baseline RVFAC was associated with a 1.53 (95% CI 1.24 to 1.88) increased risk of fatal and nonfatal CV outcomes. In conclusion, decreased right ventricular systolic function is a major risk factor for death, sudden death, HF, and stroke after MI.",

author = "Anavekar, {Nagesh S} and Hicham Skali and Mikhail Bourgoun and Ghali, {Jalal K} and K{\o}ber, {Lars Valeur} and Maggioni, {Aldo P} and McMurray, {John J V} and Eric Velazquez and Robert Califf and Pfeffer, {Marc A} and Solomon, {Scott D}",

note = "Keywords: Death, Sudden; Double-Blind Method; Female; Follow-Up Studies; Heart Failure; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Infarction; Outcome Assessment (Health Care); Stroke; Stroke Volume; Systole; Ventricular Dysfunction, Left; Ventricular Dysfunction, Right",

year = "2008",

doi = "10.1016/j.amjcard.2007.09.115",

language = "English",

volume = "101",

pages = "607--12",

journal = "Am. J. Cardiol.",

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T1 - Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study)

AU - Anavekar, Nagesh S

AU - Skali, Hicham

AU - Bourgoun, Mikhail

AU - Ghali, Jalal K

AU - Køber, Lars Valeur

AU - Maggioni, Aldo P

AU - McMurray, John J V

AU - Velazquez, Eric

AU - Califf, Robert

AU - Pfeffer, Marc A

AU - Solomon, Scott D

N1 - Keywords: Death, Sudden; Double-Blind Method; Female; Follow-Up Studies; Heart Failure; Heart Ventricles; Humans; Male; Middle Aged; Myocardial Infarction; Outcome Assessment (Health Care); Stroke; Stroke Volume; Systole; Ventricular Dysfunction, Left; Ventricular Dysfunction, Right

PY - 2008

Y1 - 2008

N2 - Severe right ventricular dysfunction independent of left ventricular ejection fraction increased the risk of heart failure (HF) and death after myocardial infarction (MI). The association between right ventricular function and other clinical outcomes after MI was less clear. Two-dimensional echocardiograms were obtained in 605 patients with left ventricular dysfunction and/or clinical/radiologic evidence of HF from the VALIANT echocardiographic substudy (mean 5.0 +/- 2.5 days after MI). Clinical outcomes included all-cause mortality, cardiovascular (CV) death, sudden death, HF, and stroke. Baseline right ventricular function was measured in 522 patients using right ventricular fractional area change (RVFAC) and was related to clinical outcomes. Mean RVFAC was 41.9 +/- 4.3% (range 19.2% to 53.1%). The incidence of clinical events increased with decreasing RVFAC. After adjusting for 11 covariates, including age, ejection fraction, and Killip's classification, decreased RVFAC was independently associated with increased risk of all-cause mortality (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.31 to 1.98), CV death (HR 1.62, 95% CI 1.30 to 2.01), sudden death (HR 1.79, 95% CI 1.26 to 2.54), HF (HR 1.48, 95% CI 1.17 to 1.86), and stroke (HR 2.95, 95% CI 1.76 to 4.95), but not recurrent MI. Each 5% decrease in baseline RVFAC was associated with a 1.53 (95% CI 1.24 to 1.88) increased risk of fatal and nonfatal CV outcomes. In conclusion, decreased right ventricular systolic function is a major risk factor for death, sudden death, HF, and stroke after MI.

AB - Severe right ventricular dysfunction independent of left ventricular ejection fraction increased the risk of heart failure (HF) and death after myocardial infarction (MI). The association between right ventricular function and other clinical outcomes after MI was less clear. Two-dimensional echocardiograms were obtained in 605 patients with left ventricular dysfunction and/or clinical/radiologic evidence of HF from the VALIANT echocardiographic substudy (mean 5.0 +/- 2.5 days after MI). Clinical outcomes included all-cause mortality, cardiovascular (CV) death, sudden death, HF, and stroke. Baseline right ventricular function was measured in 522 patients using right ventricular fractional area change (RVFAC) and was related to clinical outcomes. Mean RVFAC was 41.9 +/- 4.3% (range 19.2% to 53.1%). The incidence of clinical events increased with decreasing RVFAC. After adjusting for 11 covariates, including age, ejection fraction, and Killip's classification, decreased RVFAC was independently associated with increased risk of all-cause mortality (hazard ratio [HR] 1.61, 95% confidence interval [CI] 1.31 to 1.98), CV death (HR 1.62, 95% CI 1.30 to 2.01), sudden death (HR 1.79, 95% CI 1.26 to 2.54), HF (HR 1.48, 95% CI 1.17 to 1.86), and stroke (HR 2.95, 95% CI 1.76 to 4.95), but not recurrent MI. Each 5% decrease in baseline RVFAC was associated with a 1.53 (95% CI 1.24 to 1.88) increased risk of fatal and nonfatal CV outcomes. In conclusion, decreased right ventricular systolic function is a major risk factor for death, sudden death, HF, and stroke after MI.

U2 - 10.1016/j.amjcard.2007.09.115

DO - 10.1016/j.amjcard.2007.09.115

M3 - Journal article

C2 - 18308007

SN - 0002-9149

VL - 101

SP - 607

EP - 612

JO - Am. J. Cardiol.

JF - Am. J. Cardiol.

IS - 5

ER -

Usefulness of right ventricular fractional area change to predict death, heart failure, and stroke following myocardial infarction (from the VALIANT ECHO Study)

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