Abstract 15216: Right Ventricular Dysfunction Predictors and Prognostic Value in Ischemic and Non-Ischemic Cardiomyopathies: A Cardiac Magnetic Resonance Study

Background: Cardiac magnetic resonance imaging (CMR) is the reference standard for right ventricle (RV) quantification, however predictors and prognosis of RV dysfunction in cardiomyopathy patients, including differences between ischemic (ICM) and non-ischemic (NICM) cardiomyopathies, remain not well understood. We evaluated the factors and outcomes associated with CMR-derived reduced RV systolic function, and compared by type of cardiomyopathy. Methods: Adult cardiomyopathy patients undergoing CMR with RV quantified during 2002-2017 were retrospectively studied. Multivariable linear and Cox regression were used to identify factors associated with reduced RV ejection fraction (RVEF) and the primary endpoint (all-cause death, heart transplant or LVAD) during follow-up. Results: Amongst 771 ICM and 624 NICM patients (mean ages 62.3±11.2 and 52.8±15.9 years, 190 (24.6%) and 253 (40.5%) were female respectively), mean RVEFs were 43±14% and 43±13% respectively. The primary endpoint occurred in 455 (59.0%) ICM and 113 (18.1%) NICM patients over mean follow-up of 5.3±4.5 years. Predictors of lower RVEF in ICM were younger age, lower eGFR, lower left ventricular ejection fraction, higher right ventricular end-diastolic volume indexed and higher mitral regurgitant fraction; and in NICM were male sex, NYHA class III-IV, right bundle branch block, lower left ventricular ejection fraction, higher right ventricular end-diastolic volume and higher mitral regurgitation fraction. Reduced RVEF was associated with the primary endpoint in univariable analysis in both ICM and NICM, but only remained so for NICM in multivariable analysis of the primary endpoint as shown in the table. Conclusion: Reduced RVEF is associated with adverse prognosis, however was only independently associated with the primary endpoint in NCIM but not ICM. Key predictors of RV dysfunction in both ICM and NICM were identified, with some similar and some different predictors between them.