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Relationship between Right Ventricular Longitudinal Strain, Invasive Hemodynamics, and Functional Assessment in Pulmonary Arterial Hypertension.

Park JH, Kusunose K, Kwon DH, Park MM, Erzurum SC, Thomas JD, Grimm RA, Griffin BP, Marwick TH, Popović ZB - Korean Circ J (2015)

Bottom Line: 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 RVLSglobal (r=0.45, p<0.01) and RVLSFW (r=0.43, p<0.01).Decrease of mPAP and PVR as a result of treatment was associated with improvement of RVLS.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA. ; Cardiology Division of Internal Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.

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 RVLSglobal (r=0.45, p<0.01) and RVLSFW (r=0.43, p<0.01). The PVR change demonstrated significant correlation with improvement of RVLSglobal (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.

No MeSH data available.


Related in: MedlinePlus

Correlations between A) right ventricular global longitudinal strain and mean pulmonary arterial pressure; B) global longitudinal strain of right ventricular free wall and mean pulmonary arterial pressure; C) right ventricular global longitudinal strain and cardiac index; D) global longitudinal strain of right ventricular free wall and cardiac index; E) right ventricular global longitudinal strain and pulmonary vascular resistance; F) global longitudinal strain of right ventricular free wall and pulmonary vascular resistance. mPAP: mean pulmonary arterial pressure, RVLSglobal: right ventricular global longitudinal strain of right ventricle, RVLSFW: global longitudinal strain of right ventricular free wall, PVR: pulmonary vascular resistance.
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Figure 3: Correlations between A) right ventricular global longitudinal strain and mean pulmonary arterial pressure; B) global longitudinal strain of right ventricular free wall and mean pulmonary arterial pressure; C) right ventricular global longitudinal strain and cardiac index; D) global longitudinal strain of right ventricular free wall and cardiac index; E) right ventricular global longitudinal strain and pulmonary vascular resistance; F) global longitudinal strain of right ventricular free wall and pulmonary vascular resistance. mPAP: mean pulmonary arterial pressure, RVLSglobal: right ventricular global longitudinal strain of right ventricle, RVLSFW: global longitudinal strain of right ventricular free wall, PVR: pulmonary vascular resistance.

Mentions: Baseline RVLS are listed in Table 1. RVLSglobal was -13.3±5.0% and RVLSFW was -15.1±5.8%. In patients with advanced clinical symptoms (NYHA functional class III/IV) had significantly decreased RVLSglobal (-17.1±6.1 vs. -11.4±3.1%, p=0.01). RVLSFW showed lower in the patients with advanced symptoms without statistical significance (-18.3±7.1 vs. -13.4±4.4%, p=0.08, Fig. 1). RVLSglobal showed good correlations with 6-minute walking distance (6MWD, r=-0.54, p<0.01) and logarithmic transformation of BNP concentration (LogBNP, r=0.65, p<0.01, Fig. 2A and C). Also, RVLSFW demonstrated significant correlations with 6MWD (r=-0.57, p<0.01) and LogBNP (r=0.65, p<0.01, Fig. 2B and D). RVLSglobal had significant correlations with hemodynamic parameters including mPAP (r=0.35, p<0.05), cardiac index (r=0.50, p<0.01, and PVR (r=-0.45, p=0.01, Fig. 3A, C, and E). RVLSFW showed similar correlation with cardiac index (r=-0.47, p<0.01) and PVR (r=0.45, p=0.01). However, it did not have a significant correlation with mPAP (r=0.31, p=0.08, Fig. 3B, D, and F).


Relationship between Right Ventricular Longitudinal Strain, Invasive Hemodynamics, and Functional Assessment in Pulmonary Arterial Hypertension.

Park JH, Kusunose K, Kwon DH, Park MM, Erzurum SC, Thomas JD, Grimm RA, Griffin BP, Marwick TH, Popović ZB - Korean Circ J (2015)

Correlations between A) right ventricular global longitudinal strain and mean pulmonary arterial pressure; B) global longitudinal strain of right ventricular free wall and mean pulmonary arterial pressure; C) right ventricular global longitudinal strain and cardiac index; D) global longitudinal strain of right ventricular free wall and cardiac index; E) right ventricular global longitudinal strain and pulmonary vascular resistance; F) global longitudinal strain of right ventricular free wall and pulmonary vascular resistance. mPAP: mean pulmonary arterial pressure, RVLSglobal: right ventricular global longitudinal strain of right ventricle, RVLSFW: global longitudinal strain of right ventricular free wall, PVR: pulmonary vascular resistance.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4580699&req=5

Figure 3: Correlations between A) right ventricular global longitudinal strain and mean pulmonary arterial pressure; B) global longitudinal strain of right ventricular free wall and mean pulmonary arterial pressure; C) right ventricular global longitudinal strain and cardiac index; D) global longitudinal strain of right ventricular free wall and cardiac index; E) right ventricular global longitudinal strain and pulmonary vascular resistance; F) global longitudinal strain of right ventricular free wall and pulmonary vascular resistance. mPAP: mean pulmonary arterial pressure, RVLSglobal: right ventricular global longitudinal strain of right ventricle, RVLSFW: global longitudinal strain of right ventricular free wall, PVR: pulmonary vascular resistance.
Mentions: Baseline RVLS are listed in Table 1. RVLSglobal was -13.3±5.0% and RVLSFW was -15.1±5.8%. In patients with advanced clinical symptoms (NYHA functional class III/IV) had significantly decreased RVLSglobal (-17.1±6.1 vs. -11.4±3.1%, p=0.01). RVLSFW showed lower in the patients with advanced symptoms without statistical significance (-18.3±7.1 vs. -13.4±4.4%, p=0.08, Fig. 1). RVLSglobal showed good correlations with 6-minute walking distance (6MWD, r=-0.54, p<0.01) and logarithmic transformation of BNP concentration (LogBNP, r=0.65, p<0.01, Fig. 2A and C). Also, RVLSFW demonstrated significant correlations with 6MWD (r=-0.57, p<0.01) and LogBNP (r=0.65, p<0.01, Fig. 2B and D). RVLSglobal had significant correlations with hemodynamic parameters including mPAP (r=0.35, p<0.05), cardiac index (r=0.50, p<0.01, and PVR (r=-0.45, p=0.01, Fig. 3A, C, and E). RVLSFW showed similar correlation with cardiac index (r=-0.47, p<0.01) and PVR (r=0.45, p=0.01). However, it did not have a significant correlation with mPAP (r=0.31, p=0.08, Fig. 3B, D, and F).

Bottom Line: 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 RVLSglobal (r=0.45, p<0.01) and RVLSFW (r=0.43, p<0.01).Decrease of mPAP and PVR as a result of treatment was associated with improvement of RVLS.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA. ; Cardiology Division of Internal Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.

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 RVLSglobal (r=0.45, p<0.01) and RVLSFW (r=0.43, p<0.01). The PVR change demonstrated significant correlation with improvement of RVLSglobal (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.

No MeSH data available.


Related in: MedlinePlus