{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T05:04:07Z","timestamp":1794373447866,"version":"4.9.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,9,20]],"date-time":"2019-09-20T00:00:00Z","timestamp":1568937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"GE Vingmed"},{"name":"TomTec Imaging Systems","id":[{"id":"https:\/\/ror.org\/02w4wrz67","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Transthoracic 3D echocardiography (3DE) has been shown to be feasible and accurate to measure right ventricular (RV) ejection fraction (EF) when compared with cardiac magnetic resonance (CMR). However, RV EF, either measured with CMR or 3DE, has always been reported as normal (RV EF &amp;gt; 45%) or abnormal (RV EF\u2009\u2264\u200945%). We therefore sought to identify the partition values of RV EF to stratify RV dysfunction in mildly, moderately, or severely reduced as we are used to do with the left ventricle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We used 3DE to measure RV EF in 412 consecutive patients (55\u2009\u00b1\u200918\u2009years, 65% men) with various cardiac conditions who were followed for 3.7\u2009\u00b1\u20091.4\u2009years to obtain the partition values which defined mild, moderate, and severe reduction of RV EF (derivation cohort). Then, the prognostic value of these partition values was tested in an independent population of 446 patients (67\u2009\u00b1\u200914\u2009years, 58% men) (validation cohort). During follow-up, we recorded 59 cardiac deaths (14%) in the derivation cohort. Using K-Adaptive partitioning for survival data algorithm we identified four groups of patients with significantly different mortality according to RV EF: very low\u2009&amp;gt;\u200946%, 40.9%\u2009&amp;lt;\u2009low\u2009\u2264\u200946%, 32.1%\u2009&amp;lt;\u2009moderate\u2009\u2264\u200940.9%, and high\u2009\u2264\u200932.1%. To make the partition values easier to remember, we approximated them to 45%, 40%, and 30%. During 4.1\u2009\u00b1\u20091.2\u2009year follow-up, 38 cardiac deaths and 88 major adverse cardiac events (MACE) (cardiac death, non-fatal myocardial infarction, ventricular fibrillation, or admission for heart failure) occurred in the validation cohort. The partition values of RV EF identified in the derivation cohort were able to stratify both the risk of cardiac death (log-rank = 100.1; P\u2009&amp;lt;\u20090.0001) and MACEs (log-rank = 117.6; P\u2009&amp;lt;\u20090.0001) in the validation cohort too.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study confirms the independent prognostic value of RV EF in patients with heart diseases, and identifies the partition values of RV EF to stratify the risk of cardiac death and MACE.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjci\/jez233","type":"journal-article","created":{"date-parts":[[2019,8,23]],"date-time":"2019-08-23T15:22:11Z","timestamp":1566573731000},"page":"10-21","source":"Crossref","is-referenced-by-count":88,"title":["Development and prognostic validation of partition values to grade right ventricular dysfunction severity using 3D echocardiography"],"prefix":"10.1093","volume":"21","author":[{"given":"Denisa","family":"Muraru","sequence":"first","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Via Giustiniani 2, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0379-3283","authenticated-orcid":false,"given":"Luigi P","family":"Badano","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano, IRCCS, Cardiology Unit and Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Piazzale Brescia, 20, Milan, Italy"},{"name":"Department of Medicine and Surgery, University of Milano-Bicocca, Piazza dell'Ateneo Nuovo 1, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasufumi","family":"Nagata","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanishiku, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Surkova","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Via Giustiniani 2, Padua, Italy"},{"name":"Cardiac Division, Department of Echocardiography, Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust, Sydney Street, Chelsea, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Nabeshima","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanishiku, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Genovese","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Via Giustiniani 2, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Otsuji","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanishiku, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Guida","sequence":"additional","affiliation":[{"name":"Istituto Auxologico Italiano, IRCCS, Cardiology Unit and Department of Cardiovascular, Neural and Metabolic Sciences, San Luca Hospital, Piazzale Brescia, 20, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danila","family":"Azzolina","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Via Giustiniani 2, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Palermo","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences, University of Padua School of Medicine, Via Giustiniani 2, Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Laboratory and Transfusion Medicine, School of Medicine, University of Occupational and Environmental Health, Iseigaoka 1-1, Yahatanishiku, Kitakyushu, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,9,20]]},"reference":[{"key":"2019122003574636800_jez233-B1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1002\/ejhf.418","article-title":"The right heart in heart failure with preserved ejection fraction: insights from cardiac magnetic resonance imaging and invasive 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