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Erschienen in: The International Journal of Cardiovascular Imaging 1/2017

26.08.2016 | Original Paper

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

verfasst von: Augusto Alberto da Costa Junior, Jaquelina Sonoe Ota-Arakaki, Roberta Pulcheri Ramos, Marly Uellendahl, Frederico José Neves Mancuso, Manuel Adan Gil, Cláudio Henrique Fischer, Valdir Ambrosio Moises, Antonio Carlos de Camargo Carvalho, Orlando Campos

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 1/2017

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Abstract

Right ventricular (RV) dysfunction harbingers adverse prognosis in pulmonary arterial hypertension (PAH). Although conventional two-dimensional echocardiography (2DE) is limited for RV systolic function quantitation, RV strain can be a useful tool. The diagnostic and prognostic impact of 2DE speckle-tracking RV longitudinal strain was evaluated, including other 2DE systolic indexes, in a group of PAH patients without severe impairment of functional capacity, chronic pulmonary thromboembolism or left ventricular dysfunction. Sixty-six group I PAH patients, 67 % NYHA functional class I or II (none in IV) were studied by 2DE to obtain: RV fractional area change, tricuspid annular plane systolic excursion, RV myocardial performance index, tissue Doppler tricuspid annulus systolic velocity. Global, free wall (RVFreeWSt) and septal RV longitudinal systolic strain were obtained. RV ejection fraction by cardiac magnetic resonance (CMR-RVEF) was also assessed. All patients were followed up to 3.9 years (mean 3.3 years). Combined endpoints were hospitalization for worsening PAH or cardiovascular death. Among all the 2DE indexes of RV systolic function, RVFreeWSt exhibited the best correlation with CMR-RVEF (r = 0.83; p < 0.005). Combined endpoints occurred in 15 (22.7 %) patients (6 hospitalizations and 9 deaths). Multivariate analysis identified RVFreeWSt ≤−14 % as the only 2DE independent variable associated with combined endpoints [HR 4.66 (1.25–17.37); p < 0.05]. We conclude 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.
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Metadaten
Titel
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
verfasst von
Augusto Alberto da Costa Junior
Jaquelina Sonoe Ota-Arakaki
Roberta Pulcheri Ramos
Marly Uellendahl
Frederico José Neves Mancuso
Manuel Adan Gil
Cláudio Henrique Fischer
Valdir Ambrosio Moises
Antonio Carlos de Camargo Carvalho
Orlando Campos
Publikationsdatum
26.08.2016
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 1/2017
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-016-0966-1

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