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The impact of right ventricle systolic dysfunction on prognosis in patients with reduced left ventricular ejection fraction and implanted cardioverter defibrillator

Authors: Ushakov R.Yu., Bazylev V.V., Durmanov S.S., Palkova V.A., Mikulyak A.I.

Company: Federal Center for Cardiovascular Surgery, Penza, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2025-19-1-88-97

For citation: Ushakov R.Yu., Bazylev V.V., Durmanov S.S., Palkova V.A., Mikulyak A.I. The impact of right ventricle systolic dysfunction on prognosis in patients with reduced left ventricular ejection fraction and implanted cardioverter defibrillator. Creative Cardiology. 2025; 19 (1): 88–97 (in Russ.). DOI: 10.24022/1997-3187-2025-19-1-88-97

Received / Accepted:  20.01.2025 / 17.02.2025

Keywords: heart failure with preserved ejection fraction valvular heart disease high sensitivity troponin I



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Abstract

Objective – to study the relationship between systolic dysfunction of the pancreas according to cardiac MRI and the probability of justified activation of ICD and death from CVD in patients with reduced LVEF and implanted ICD.

Material and methods. Electronic medical records of 86 patients who had 1 or 2-chamber ICD implanted were retrospectively evaluated. The study included patients with ICMP or DCMP and LVEF ≤ 35% without a history of persistent VF/VT episodes. Patients underwent MRI of the heart with contrast on a Siemens Magnetom Avanto, 1.5 Tl MR tomograph. The threshold value of EF for determining systolic dysfunction of the right ventricle was selected based on past studies and amounted to 45%. The patients were monitored using one of the Home Monitoring (BIOTRONIK) or CareLink (Medtronic) remote monitoring networks.

Results. The median follow-up period was 24 months (14–36 months). Justified ICD triggers occurred in 33 patients, 23 patients died, 46 patients (53%) reached the endpoint, of which 33 (64.7%) in the LVEF group < 45% and 13 (37.1%) in the LVEF group ≥ 45%, the difference is statistically significant. A statistically significant multifactorial regression model (x2 = 18.884; p = 0.001) was constructed using RVF<45%, GFR, ICMP, and APG > 26%. To determine the quality of the resulting model, a ROC curve is constructed. The area under the ROC curve is 0.787 ± 0.49 (95% DI 0.689–0.883). The value of the function at the cut-off point was 0.4555 (sensitivity 77.8%, specificity 76.35%).

Conclusion. The study shows the potential benefit of preoperative screening of this indicator in patients undergoing ICD implantation in order to further stratify arrhythmic risk and death from CVD.

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About Authors

  • Roman Yu. Ushakov, Cardiologist; ORCID
  • Vladlen V. Bazylev, Dr. Med. Sci., Chief Physician; ORCID
  • Sergey S. Durmanov, Cand. Med. Sci., Head of the Surgical treatment of complex cardiac arrhythmias and pacing; ORCID
  • Veronika A. Palkova, Radiologist; ORCID
  • Artur I. Mikulyak, Cand. Med. Sci., Head of the cardio-surgical department № 1; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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