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Relationship between right ventricular longitudinal strain, invasive hemodynamics, and functional assessment in pulmonary arterial hypertension


Park, JH and Kusunose, K and Kwon, DH and Park, MM and Erzurum, SC and Thomas, JD and Grimm, RA and Griffin, BP and Marwick, TH and Popovi, ZB, Relationship between right ventricular longitudinal strain, invasive hemodynamics, and functional assessment in pulmonary arterial hypertension, Korean Circulation Journal, 45, (5) pp. 398-407. ISSN 1738-5520 (2015) [Refereed Article]


Copyright Statement

Copyright 2015 The Korean Society of Cardiology Licenced under the terms of the Creative Commons Attribution Non-Commercial License

DOI: doi:10.4070/kcj.2015.45.5.398


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, -175 vs. -123%, p<0.01) and RV free wall (RVLSFW, -195 vs. -144%, 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, 5413 to 4616 mmHg, p=0.03) and PVR (115 to 62 wood units, p < 0.01) were significantly decreased with pulmonary vasodilator treatment. RVLSglobal (-125 to -165%, p<0.01) and RVLSFW (-145 to -185%, 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.

Item Details

Item Type:Refereed Article
Keywords:familial primary pulmonary hypertension, heart ventricles, ventricular function, right
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Marwick, TH (Professor Tom Marwick)
ID Code:103378
Year Published:2015
Web of Science® Times Cited:17
Deposited By:Menzies Institute for Medical Research
Deposited On:2015-10-07
Last Modified:2016-04-11
Downloads:153 View Download Statistics

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