الفهرس 
Heart FailureOnly 14 pages are availabe for public view
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Abstract
By definition, heart failure is the inability of the heart to maintain or increase cardiac output (CO) at a rate commensurating with aerobic requirements. Symptoms of heart failure may first become manifest as dyspnea or fatigue during activity (Chatterjee, 2002). Patients with chronic heart failure (CHF) experience marked reduction in their exercise capacity which has detrimental effects on their activities of daily living, health- related quality of life (HRQoL), and ultimately their hospital admission rate and mortality (Tavazzi et al., 2001). CPET testing is regarded as the gold standard for assessment of functional capacity in HF patients (Fleg et al., 2000). However, the 6MWT constitutes a suitable alternative for CPET testing, with the added benefits of being simple, well-tolerated, widely used, and possible to perform under any conditions (Carvalho et al, 2011). The main focus has traditionally been placed on the functional assessment of the left ventricle. Therefore, the current body of literature examining the right ventricle and its influence on the pathophysiological processes in heart failure has been limited (Brieke et al., 2005). Our study was conducted on 70 patients with chronic stable HF with (EF ≤40%) presenting to Ain Shams University hospital rehabilitation clinic with grade I to III NYHA classification. Each patient performed a 6MWT and complete a forum of MLHFQ, offered an ECG gated echocardiographic study for assessment of systolic and diastolic functions of right & left ventricles. The goal of the study was to determine the correlation between Right ventricular echocardiographic variables, functional status assessed by 6MWD & quality of life assessed by MLHFQ in HF patients ―NYHA class I - III‖. Comparing the 6MWD of each patient with the different right ventricular echocardiographic variables of systolic & diastolic dysfunction revealed that the higher the RVSP the less achieved the 6MWD. We also found the higher the TAPSE the higher the achieved 6MWD. Moreover, RVSP, TAPSE, tricuspid E/E‘, RVFAC&RV dilatation were significantly higher in patients with poor walking performance (<300 meters). Multivariate analysis of these echocardiographic variables& Age revealed that RVSP &age are independent predictor of 6MWD & thus independent predictor of functional capacity in HF patients. Accordingly, among different echocardiographic parameters, RVSP can be considered as an independent surrogate predictor of functional capacity in HF patients.