Introduction .– The evaluation of the prognosis of patients with dilated cardiomyopathy (DCM) is an essential step in their care. Doppler echocardiography is a noninvasive, reliable and available method for the diagnosis and also for the prognosis’s study of these patients. But the study ultrasound of the right ventricle (RV) is not a part of the practice of the cardiologist.

Purpose of study .– Determine which of the echocardiographic parameters that assess systolic and diastolic function of the RV, those predicting of the occurrence of secondary cardiac events (death, hospitalization for decompensated heart failure and ventricular arrhythmias poorly tolerated) in patients with DCM.

Materials and methods .– Prospective study in 61 patients with DCM symptomatic heart failure (class II→IV NYHA) who are stable with medical treatment. All these patients received a conventional echocardiographic examination with emphasis on studying the RV parameters: fractional shortening surface RV (FRSRV), the systolic excursion of the tricuspid annulus to the TM (TAPS), and systolic pulmonary artery pressure (SPAP), that is completed by a study at tissue pulsed Doppler at the tricuspid annulus wave (Sa, Ea and Aa). All patients were regularly monitored. We studied the correlation between echocardiographic parameters of RV and the occurrence of secondary cardiac events.

Results .– There were 61 patients in a period from February 2006 to September 2007. The average age of patients was 62 ± 9.86 years (40 to 81 ans) with a sex-ratio of 2 m/1 woman. Forty-eight percent of patients were in NYHA class III. The average fractional ejection of left ventricle was 29 ± 7.2%. DCM was ischemic in 59% of cases. During follow-up (11 ± 5 months), 5 patients died, 22 were hospitalized for decompensated heart failure and 2 patients had a ventricular tachycardia. We have shown that the parameters predictors of mortality are: TAPS < 12 mm and a FRSRV < 33%. Parameters predictive of hospitalization for decompensated heart failure: SPAP > 42 mm Hg, RV FRS < 39%, a TAPS < 15 mm and wave velocities Sa, Ea and Aa or DTI tricuspid annulus < respectively 10.1 cm/s to 6.09 cm/s and 12.75 cm/s. Echocardiographic parameters predictive of cardiac events overall were: SPAP > 42 mm Hg, a TAPS < 11.5, a FRSRV < 38%, Sa and Aa waves to the DTI tricuspid lower respectively at 10.2 cm/s and 14 cm/s. In multivariate analysis, only the FRSRV < 38% was a factor directly related to the occurrence of cardiac events overall.

Conclusion .– In current practice, assessment of the prognosis of patients with DCM is limited to consideration of the left ventricle. The evaluation of echocardiographic parameters of systolic and diastolic RV functions would be very useful for better stratification of prognosis of these patients.