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Background <p>Right ventricular (RV) dysfunction has emerged as a potential predictor of adverse cardiac outcomes, including sudden cardiac death (SCD) and severe ventricular arrhythmias (VAs). To clarify the role of RV dysfunction in arrhythmic risk assessment, we conducted a systematic review and meta-analysis to evaluate its prognostic value for SCD and VA.</p> Methods <p>A systematic search of PubMed, Embase, and Web of Science was conducted from inception to February 2025. The primary endpoint was a composite of SCD or severe VA, including ventricular tachycardia, ventricular fibrillation, or appropriate implantable cardioverter-defibrillator therapy. RV dysfunction was defined as impaired RV fractional area change, RV ejection fraction, or RV strain. A random-effects model was used to calculate pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs).</p> Results <p>Of 1296 identified articles, seven studies comprising 1475 patients met the inclusion criteria. RV dysfunction was present in 541 patients. The mean follow-up duration was 2.9&#xa0;years. RV dysfunction was significantly associated with an increased risk of SCD and VA (OR 3.69; 95% CI 2.40–5.66; <i>p</i> &lt; 0.01). Secondary analysis showed that patients who experienced SCD or VA had significantly lower RVFAC compared to those without events (MD − 5.67; 95% CI − 8.73 to − 2.60; <i>p</i> &lt; 0.01), whereas LVEF did not differ significantly between groups (MD − 0.59; 95% CI − 4.10 to 2.92; <i>p</i> = 0.74).</p> Conclusions <p>RV dysfunction is associated with an increased risk of SCD and VA, indicating that RV parameters may hold prognostic value in arrhythmic risk stratification.</p> Graphical Abstract <p></p>

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Right ventricular dysfunction: an overlooked predictor of sudden cardiac death and arrhythmic events—a meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月2日

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  • Toshinori Chiba,
  • Amelie Beblo,
  • Nora Wainstejn,
  • Julia Lueg,
  • Robert Hättasch,
  • Felix Hohendanner,
  • Verena Tscholl,
  • Nikolaos Dagres,
  • Gerhard Hindricks,
  • Wilhelm Haverkamp

摘要

Background

Right ventricular (RV) dysfunction has emerged as a potential predictor of adverse cardiac outcomes, including sudden cardiac death (SCD) and severe ventricular arrhythmias (VAs). To clarify the role of RV dysfunction in arrhythmic risk assessment, we conducted a systematic review and meta-analysis to evaluate its prognostic value for SCD and VA.

Methods

A systematic search of PubMed, Embase, and Web of Science was conducted from inception to February 2025. The primary endpoint was a composite of SCD or severe VA, including ventricular tachycardia, ventricular fibrillation, or appropriate implantable cardioverter-defibrillator therapy. RV dysfunction was defined as impaired RV fractional area change, RV ejection fraction, or RV strain. A random-effects model was used to calculate pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs).

Results

Of 1296 identified articles, seven studies comprising 1475 patients met the inclusion criteria. RV dysfunction was present in 541 patients. The mean follow-up duration was 2.9 years. RV dysfunction was significantly associated with an increased risk of SCD and VA (OR 3.69; 95% CI 2.40–5.66; p < 0.01). Secondary analysis showed that patients who experienced SCD or VA had significantly lower RVFAC compared to those without events (MD − 5.67; 95% CI − 8.73 to − 2.60; p < 0.01), whereas LVEF did not differ significantly between groups (MD − 0.59; 95% CI − 4.10 to 2.92; p = 0.74).

Conclusions

RV dysfunction is associated with an increased risk of SCD and VA, indicating that RV parameters may hold prognostic value in arrhythmic risk stratification.

Graphical Abstract