Background: Right ventricular ejection fraction (RVEF) is a strong predictor of adverse outcome in patients with heart failure and LV dysfunction. RVEF can be calculated by first pass (FP) ventriculography as part of gated SPECT MPI used for ischemia, sacr, as well as for viability assessment. However, echocardiography is the useful modality for evaluation and follow up these patients. RVEF is less frequently measured. The aim of this study is to investigate the correlation of RVEF with right heart parameters by 2D echo.
Methods: Patients with LV dysfunction who referred for gated SPECT underwent first pass ventriculography by Tc 99m sestamibi prior gated SPECT . These pts underwent TTE with 14 variables of RV and RA. Spearman correlation for small and non parametric study group of each echo variable with RVEF by nuclear study was done.
Results: Eighteen pts were studied, 14 men. Time interval between FP gated SPECT and TTE was median 4 weeks. LVEF by gated SPECT was 29±8% and RVEF by FP was 48±14%. There were 11 pts with normal RVEF>40% and 7 with reduced RVEF. The variables calculated by TTE were: RVOT prox. RVOT dist. RVD (diameter)1,2,3 (apex mid and basal levels). RV end diastolic area and end systolic area, fructional area contraction (FAC)%, TR peak velocity, RA pressure, PHT, IVC.. A significant correlation was found between RVEF and RVOT prox (-0.58, p,0.015), RV Distal (-0.8 p<0.001), ED and ES areas (-0.85, p<0.0010), FAC% (-0.68, p=0.002). As this is a small cohort, it was impossible to perform multi variable analysis in order to predict which one of the echo variables can significantly predict RVEF.
Conclusion: In this preliminary study, RVEF by FP with gated SPECT in patients with LV dysfunction was reduced in more than third and it was significantly correlated by several echo variables related to RV diameters ; proximal RVOT, RVD apex, RV ES and ED areas, FAC%.
