RIGHT VENTRICULAR FUNCTION ON ROUTINE ECHOCARDIOGRAPHY AS A PREDICTOR OF SHORT-TERM OUTCOMES IN ACUTE HEART FAILURE ADMISSIONS IN A RESOURCE-LIMITED TERTIARY CARE HOSPITAL IN PAKISTAN

Background: Acute heart failure (AHF) is associated with high short-term morbidity and mortality. While left ventricular function is routinely evaluated, right ventricular dysfunction has emerged as an important determinant of outcomes. Simple echocardiographic parameters such as tricuspid annular plane systolic excursion (TAPSE) and right ventricular fractional area change (FAC) may provide useful prognostic information in patients hospitalized with AHF. The objective of this study was to evaluate right ventricular function using TAPSE and FAC and evaluate their association with short-term clinical outcomes in patients with acute heart failure. Methods: This prospective observational study included 120 patients admitted with acute heart failure at a tertiary care Cardiology Unit. Transthoracic echocardiography within 24 hours assessed left ventricular ejection fraction (LVEF), TAPSE, FAC, and pulmonary artery systolic pressure. Right ventricular dysfunction was defined as TAPSE <16 mm or FAC <35%. Patients were monitored during hospitalization for short-term outcomes including ICU admission, inotropic support, mechanical ventilation, worsening renal function, prolonged hospital stay, and in-hospital mortality. Results: The mean age of patients was 54.62±8.15 years and 65.8% were male. Reduced TAPSE and FAC were observed in 46.7% patients. ICU admission, need for inotropic support, and mechanical ventilation were significantly more frequent in patients with reduced TAPSE and FAC (p?0.01). Prolonged hospital stay was significantly associated with reduced FAC (p<0.05). Echocardiographic differences between survivors and non-survivors were not statistically significant. Conclusion: RV dysfunction is associated with adverse short-term outcomes in AHF and may aid in early risk stratification. Pak J Physiol 2029;22(1):46–51, DOI: https://doi.org/10.69656/pjp.v22i1.1942