{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:19:42Z","timestamp":1780330782947,"version":"3.54.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T00:00:00Z","timestamp":1691107200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004726","name":"Ministry of Health","doi-asserted-by":"publisher","award":["NV19-02-00130"],"award-info":[{"award-number":["NV19-02-00130"]}],"id":[{"id":"10.13039\/501100004726","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Right ventricular (RV) function is currently being evaluated solely according to the properties of RV myocardium. We have tested a concept that in patients with heart failure with reduced ejection fraction (HFrEF), RV assessment should integrate the information about both RV function as well as size.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 836 stable patients with HFrEF (LVEF 23.6\u2009\u00b1\u20095.8%, 82.8% males, 68% NYHA III\/IV) underwent echocardiographic evaluation and were prospectively followed for a median of 3.07 (IQRs 1.11; 4.89) years for the occurrence of death, urgent heart transplantation or implantation of mechanical circulatory support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>RV size (measured as RV-basal diameter, RVD<jats:sub>1<\/jats:sub>) was significantly associated with an adverse outcome independent of RV dysfunction grade (<jats:italic>p<\/jats:italic>\u2009=\u20090.0002). The prognostic power of RVD<jats:sub>1<\/jats:sub> was further improved by indexing to body surface area (RVD<jats:sub>1<\/jats:sub>i, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.05 compared to non-indexed value). A novel parameter named RV global dysfunction score (RVGDs) was calculated as a product of RVD<jats:sub>1<\/jats:sub>i and the degree of RV dysfunction (1\u20134 for preserved RV function, mild, moderate and severe dysfunction, respectively). RVGDs showed a superior prognostic role compared to RV dysfunction grade alone (\u0394AUC &amp;gt;0.03, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.0001). In every subgroup of RVGDs (&amp;lt;20, 20\u201340, 40\u201360, &amp;gt;60), patients with milder degree of RV dysfunction but more dilated RV had similar outcome as those with more severe degree of RV dysfunction but smaller RV size (all <jats:italic>p<\/jats:italic>\u2009&amp;gt;\u20090.50), independent of tricuspid regurgitation severity and degree of pulmonary hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>RV dilatation is a manifestation of RV dysfunction. The evaluation of RV performance should integrate the information about both RV size and function.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2023.1194174","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T12:20:34Z","timestamp":1691151634000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":16,"title":["Right ventricular global dysfunction score: a new concept of right ventricular function assessment in patients with heart failure with reduced ejection fraction 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