RIGHT VENTRICULAR ISOVOLUMIC RELAXATION TIME ASSESSED BY TISSUE DOPPLER IMAGING IN RISK STRATIFICATION IN PATIENTS WITH CHRONIC HEART FAILURE

Aim: The assesment of prognostic significance of right ventricular isovolumic relaxation time (IVRT) measured by tissue doppler imaging (TDI) in patiens with chronic heart failure and its relation to parameters of invasive hemodynamics.
Patients and methods: One hundred and eight patients with chronic heart failure (NYHA II-IV) underwent in the beginning of the study echocardiography with TDI of tricuspid anulus motion and catheterization of the right heart. Patients were followed-up with respect to cardiac mortality and non-fatal cardiac events related to heart failure as hospitalization for cardiac decompensation or need for implantation of cardioverter-defibrillator for malignant ventricular arrhytmias. The mean follow up period was 18 months.
Results: There were thirty one cardiac events, 12 patients from this number died.
The value of IVRT was significantly lower in patients who died (62 msec) against patients who survive (98 msec), p< 0,05 (Mann-Whitney U test). The Cox regression analysis showed significant predictive potential for overall survival in combination with other parameters (Tei index, IVA) (relative risk 0,98; p<0,05).
Conclusion: The assesment of right ventricular isovolumic relaxation time by TDI is only auxiliary instrumental method for risk stratification of patients with chronic heart failure with increased risk of cardiac related death.