A STUDY ON ASSESSMENT OF RIGHT VENTRICULAR FUNCTION BY RIGHT VENTRICULAR OUTFLOW TRACT SYSTOLIC EXCURSION IN ADULT POPULATION ATTENDING A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Abstract

Objectives: The objectives of the study are as follows:

(1) to assess the right ventricular function (RVF) by right ventricle outflow tract systolic excursion through M-mode echocardiography and (2) to correlate the right ventricle outflow tract systolic excursion value with other 2D echocardiographic methods of RVF assessment.

Methods: The present observational prospective study was conducted in the department of cardiology, Apollo Multispeciality Hospital, Kolkata, among patients visiting the cardiology outpatient department and inpatient department from August 2021 to August 2022 to assess the RVF by right ventricle outflow tract systolic excursion through M-mode echocardiography and correlate the results with other methods (tricuspid annulus plane systolic excursion, tissue Doppler imaging, pulmonary artery pressure, fractional area change [FAC]) of RVF assessment.

Results: Majority of the patients in both groups belong to the age group of 51–60 years (45.5%), followed by 61–70 years (29.5%) and 41–50 years (20.5%). Patients with right ventricular (RV) dysfunction were more aged as compared to normal RVF. The mean body mass index (BMI) was significantly higher and mean hemoglobin level was significantly lower in patients with RV dysfunction as compared to the control group (p<0.05). Both systolic and diastolic blood pressures were significantly higher among the patient group than in the control group (p<0.05). We found that right ventricular outflow tract systolic excursion (RVOT-SE), tricuspid annular plane systolic excursion (TAPSE), tissue Doppler myocardial performance index, left ventricular (LV) ejection fraction (%), and FAC were significantly lower among patient group than control group (p<0.01). TAPSE ≤17 mm was the best cutoff value that differentiates patients with RV systolic dysfunction from healthy individuals with normal RV systolic function. There were 67% of patients with ≤17 mm and 33% had >17 mm TAPSE.

Conclusion: Our study concludes that RVOT-SE is a highly sensitive and specific method for diagnosing reduced RV systolic function patients. RVOT SE is not accurate as a sole parameter, but its high values can be used as an indicator for normal RV systolic function. It is simple to get, requiring one easy and reproducible M-Mode measurement from the parasternal short-axis view.