PREVALENCE OF RIGHT VENTRICULAR DYSFUNCTION BY ECHOCARDIOGRAPHY PRESENTING WITH ISCHEMIC HEART DISEASE IN SHEIKH ZAYED HOSPITAL RAHIM YAR KHAN
DOI:
https://doi.org/10.71000/dxp58622Keywords:
Echocardiography, Ischemic heart disease, TAPSE, Ventricular Function, RVSTDI, , Right Ventricular Dysfunction, Left Ventricular DysfunctionAbstract
Background: Ischemic heart disease (IHD) remains the leading cause of mortality worldwide, contributing significantly to cardiovascular-related deaths. Right ventricular (RV) dysfunction frequently complicates IHD, especially in the presence of left ventricular (LV) failure or infarction. RV impairment is associated with poorer prognoses, including higher rates of heart failure, arrhythmias, and mortality. Echocardiography, being non-invasive, affordable, and widely available, remains the first-line modality for assessing cardiac function, including RV performance in IHD patients.
Objective: To determine the prevalence of right ventricular dysfunction among patients with ischemic heart disease diagnosed on echocardiography in Rahim Yar Khan.
Methods: An analytical cross-sectional study was conducted at Sheikh Zaid Medical College and Hospital, Rahim Yar Khan, over a three-month period from February to April 2025. A total of 110 patients, aged 32 to 75 years, with confirmed ischemic heart disease and left ventricular dysfunction were enrolled through non-probability sampling. Patients with congenital cardiac abnormalities, myocarditis, or peripartum cardiomyopathy were excluded. Echocardiographic assessment was performed using a GE Vivid S6 machine with a 3–5 MHz sector probe, evaluating parameters including Tricuspid Annular Plane Systolic Excursion (TAPSE) and RV systolic tissue Doppler imaging (RVSTDI). Data were analyzed using SPSS version 25.
Results: Of the 110 patients (62 males, 48 females), RV dysfunction was identified in 48 individuals (43.6%), while 62 (56.4%) had preserved RV function. The mean ejection fraction was 36.3% ± 7.1, with a mean TAPSE of 13.65 mm ± 5.85. TAPSE was significantly lower in patients with RV dysfunction (mean 8.29 mm ± 3.57) compared to those without (mean 17.81 mm ± 3.33), p < 0.001.
Conclusion: RV dysfunction was prevalent in patients with ischemic heart disease, particularly among those with more severe LV impairment. Early detection through echocardiography is vital for improving clinical outcomes.
References
Monisha KG, Prabu P, Chokkalingam M, Murugesan R, Milenkovic D, Ahmed S. Clinical utility of brain-derived neurotrophic factor as a biomarker with left ventricular echocardiographic indices for potential diagnosis of coronary artery disease. Sci Rep. 2020;10(1):16359.
de Cillia N, Finsterer J, Campean R, Noorian A, Winkler-Dworak M, Stöllberger C. Coronary Angiography in Patients With Left Ventricular Hypertrabeculation/Noncompaction. Tex Heart Inst J. 2024;51(1).
Rao S, Weng M, Lian R, Zhuo Y, Lin J, You D, et al. Correlation between coronary calcification and cardiac structure in non-dialysis patients with chronic kidney disease. ESC Heart Fail. 2025;12(1):199-210.
Manganaro R, Cusmà-Piccione M, Carerj S, Licordari R, Khandheria BK, Zito C. Echocardiographic Patterns of Abnormal Septal Motion: Beyond Myocardial Ischemia. J Am Soc Echocardiogr. 2023;36(11):1140-53.
Malagoli A, Fanti D, Albini A, Rossi A, Ribichini FL, Benfari G. Echocardiographic Strain Imaging in Coronary Artery Disease: The Added Value of a Quantitative Approach. Cardiol Clin. 2020;38(4):517-26.
Negahban Z, Rezaei M, Daei MM, Mirzadeh M. Evaluation of the Systolic and Diastolic Right Ventricular Function: A Comparison Between Diabetes, Prediabetes and Normal Patients Without Coronary Artery Disease. Curr Probl Cardiol. 2021;46(6):100817.
Kumar AFS, Ojha V, Veettil ST, Mantoo M, Singh D, Pandey NN, et al. Incremental Role of Cardiac CT Angiography in the Assessment of Left Ventricular Diastolic Function in Patients With Suspected Coronary Artery Disease With Normal Ejection Fraction: A Comparison With Transthoracic Echocardiography. Echocardiography. 2025;42(1):e70069.
Eldeib M, Qaddoura F, Sadek M, Abuelatta R, Nagib A. Innovative method to diagnose coronary Cameral fistula by contrast echocardiography. Echocardiography. 2021;38(2):343-6.
Fukunaga N, Ribeiro RVP, Lafreniere-Roula M, Manlhiot C, Badiwala MV, Rao V. Left Ventricular Size and Outcomes in Patients With Left Ventricular Ejection Fraction Less Than 20. Ann Thorac Surg. 2020;110(3):863-9.
Kim H, Kim IC, Lee CH, Cho YK, Park HS, Nam CW, et al. Myocardial Contrast Uptake in Relation to Coronary Artery Disease and Prognosis. Ultrasound Med Biol. 2020;46(8):1880-8.
Liu Z, Chang C, Liu J, Wang Q. Right Ventricular Rupture in Redo Coronary Artery Bypass Grafting. Heart Surg Forum. 2020;23(5):E685-e8.
Cao R, Wu X, Zheng X. Right ventricular-pulmonary artery coupling is an independent risk factor for coronary artery lesions in children with Kawasaki disease. Coron Artery Dis. 2024;35(4):328-32.
Matta A, Delmas C, Campelo-Parada F, Lhermusier T, Bouisset F, Elbaz M, et al. Takotsubo cardiomyopathy. Rev Cardiovasc Med. 2022;23(1):38.
Unkun T, Demirci K, Fidan S, Derebey ST, Sengör BG, Yılmaz C, et al. Usability of myocardial work parameters in demonstrating myocardial involvement in INOCA patients. J Clin Ultrasound. 2024;52(7):827-36.
Huang R, Jin J, Zhang P, Yan K, Zhang H, Chen X, et al. Use of speckle tracking echocardiography in evaluating cardiac dysfunction in patients with acromegaly: an update. Front Endocrinol (Lausanne). 2023;14:1260842.
Cameli, M., & Mondillo, S. (2021). Right ventricular dysfunction in patients with ischemic heart disease: a speckle-tracking echocardiography study. Journal of Cardiovascular Medicine, 22(12), 641-648.
Dini, F. L., Pugliese, N. R., Ameri, P., Attanasio, U., Badagliacca, R., Correale, M., Mercurio, V., Tocchetti, C. G., Agostoni, P., & Palazzuoli, A. (2023). Right ventricular failure in left heart disease: from pathophysiology to clinical manifestations and prognosis. Heart Failure Reviews, 28(4), 757-766.
Jensen, R. V., Hjortbak, M. V., & Bøtker, H. E. (2020). Ischemic heart disease: an update. Seminars in nuclear medicine,
Nabeshima, Y., & Takeuchi, M. (2020). Right ventricular dysfunction in patients with ischemic heart disease: a speckle-tracking echocardiography study. European Heart Journal-Cardiovascular Imaging, 21(12), 1231-1238.
Sanders, J. L., Koestenberger, M., Rosenkranz, S., & Maron, B. A. (2020). Right ventricular dysfunction and long-term risk of death. Cardiovascular Diagnosis and Therapy, 10(5), 1646.
Tromp, J., & Westenbrink, B. D. (2020). Right ventricular dysfunction in patients with ischemic heart disease: a 8 systematic review and meta-analysis. European Journal of Heart Failure, 22(12), 2121-2131.
Ullah, R., Ali, J., Bilal, A., Jan, D. A., Rahim, A., & Sajjad, W. (2023). Frequency of right ventricular infarction in patients with acute inferior wall myocardial infarction presenting at a tertiary care hospital, Peshawar. Pakistan Heart Journal, 56(2), 163-166.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Saba Ajmal, Khadija Tahir, Bushra Islam, Zainab Mehboob, Aqsa Khalid, Rabeel Arif, Hafsa Umair, Maria Yaseen, Ahmad Bilal (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
