Relationship between Right Ventricular Longitudinal Strain, Invasive Hemodynamics, and Functional Assessment in Pulmonary Arterial Hypertension
Jae-Hyeong Park,Jae-Hyeong Park,Kenya Kusunose,Kenya Kusunose,Deborah H Kwon,Margaret M. Park,Margaret M. Park,Serpil C. Erzurum,Serpil C. Erzurum,James D. Thomas,Richard A. Grimm,Brian P. Griffin,Thomas H. Marwick,Thomas H. Marwick,Zoran B. Popović +14 more
TLDR
RVLS correlates with functional and invasive hemodynamic parameters in PAH patients and decrease of mPAP and PVR as a result of treatment was associated with improvement of RVLS.Abstract:
Background and Objectives: Right ventricular longitudinal strain (RVLS) is a new parameter of RV function. We evaluated the relationship of RVLS by speckle-tracking echocardiography with functional and invasive parameters in pulmonary arterial hypertension (PAH) patients. Subjects and Methods: Thirty four patients with World Health Organization group 1 PAH (29 females, mean age 45±13 years old). RVLS were analyzed with velocity vector imaging. Results: Patients with advanced symptoms {New York Heart Association (NYHA) functional class III/IV} had impaired RVLS in global RV (RVLSglobal, -17±5 vs. -12±3%, p<0.01) and RV free wall (RVLSFW, -19±5 vs. -14±4%, p<0.01 to NYHA class I/II). Baseline RVLSglobal and RVLSFW showed significant correlation with 6-minute walking distance (r=-0.54 and r=-0.57, p<0.01 respectively) and logarithmic transformation of brain natriuretic peptide concentration (r=0.65 and r=0.65, p<0.01, respectively). These revealed significant correlations with cardiac index (r=-0.50 and r=-0.47, p<0.01, respectively) and pulmonary vascular resistance (PVR, r=0.45 and r=0.45, p=0.01, respectively). During a median follow-up of 33 months, 25 patients (74%) had follow-up examinations. Mean pulmonary arterial pressure (mPAP, 54±13 to 46±16 mmHg, p=0.03) and PVR (11±5 to 6±2 wood units, p<0.01) were significantly decreased with pulmonary vasodilator treatment. RVLSglobal (-12±5 to -16±5%, p<0.01) and RVLSFW (-14±5 to -18±5%, p<0.01) were significantly improved. The decrease of mPAP was significantly correlated with improvement of RVLS global (r=0.45, p<0.01) and RVLSFW (r=0.43, p<0.01). The PVR change demonstrated significant correlation with improvement of RVLS global (r=0.40, p<0.01). Conclusion: RVLS correlates with functional and invasive hemodynamic parameters in PAH patients. Decrease of mPAP and PVR as a result of treatment was associated with improvement of RVLS. (Korean Circ J 2015;45(5):398-407)read more
Citations
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Journal ArticleDOI
Strain Analysis of the Right Ventricle Using Two-dimensional Echocardiography
Ju-Hee Lee,Jae-Hyeong Park +1 more
TL;DR: RVGLS measurement, normal reference values, and the clinical importance of RVGLS are discussed; and RV global longitudinal strain (RVGLS) can be used as an objective index of RV systolic function with prognostic significance.
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Echocardiographic assessment of the right ventricle: Impact of the distinctly load dependency of its size, geometry and performance
Michael Dandel,Roland Hetzer +1 more
TL;DR: Special attention is focused on the usefulness of RV echo-evaluation in relation to load for proper decision making before ventricular assist-device implantation in patients with CHF and for optimal timing of listing procedures to transplantation in Patients with end-stage pre-capillary PH.
Journal ArticleDOI
Diagnostic and prognostic value of right ventricular strain in patients with pulmonary arterial hypertension and relatively preserved functional capacity studied with echocardiography and magnetic resonance
Augusto Alberto da Costa Junior,Jaquelina S. Ota-Arakaki,Roberta Pulcheri Ramos,Marly Uellendahl,Frederico José Neves Mancuso,Manuel Adán Gil,Claudio Henrique Fischer,Valdir Ambrósio Moisés,Antonio Carlos de Camargo Carvalho,Orlando Campos +9 more
TL;DR: It is concluded that RVFreeWSt may be a suitable non-geometric 2DE surrogate of CMR-RVEF in PAH patients, constituting a powerful independent predictor of long-term outcome in this cohort with relatively preserved functional capacity.
Journal ArticleDOI
Evaluation of the right ventricle by echocardiography: particularities and major challenges
Michael Dandel,Roland Hetzer +1 more
TL;DR: This review discusses the particular challenges and limits in obtaining accurate measurements of RV anatomical and functional parameters and focuses primarily on the difficulties in proper interpretation of the highly load dependent RV ECHO-parameters which complicates the use of this valuable diagnostic and surveillance technique.
Journal ArticleDOI
Two-dimensional Echocardiographic Assessment of Myocardial Strain: Important Echocardiographic Parameter Readily Useful in Clinical Field
TL;DR: The measurement and clinical utility of 2-dimensional strain analysis in various cardiovascular diseases is described.
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