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Relationship between right ventricular longitudinal strain, invasive hemodynamics, and functional assessment in pulmonary arterial hypertension
Citation
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]
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Copyright Statement
Copyright 2015 The Korean Society of Cardiology Licenced under the terms of the Creative Commons Attribution Non-Commercial License http://creativecommons.org/licenses/by-nc/3.0/
DOI: doi:10.4070/kcj.2015.45.5.398
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.
Item Details
Item Type: | Refereed Article |
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Keywords: | familial primary pulmonary hypertension, heart ventricles, ventricular function, right |
Research Division: | Medical and Health Sciences |
Research Group: | Cardiorespiratory Medicine and Haematology |
Research Field: | Cardiology (incl. Cardiovascular Diseases) |
Objective Division: | Health |
Objective Group: | Clinical Health (Organs, Diseases and Abnormal Conditions) |
Objective Field: | Cardiovascular System and Diseases |
UTAS Author: | Marwick, TH (Professor Tom Marwick) |
ID Code: | 103378 |
Year Published: | 2015 |
Web of Science® Times Cited: | 11 |
Deposited By: | Menzies Institute for Medical Research |
Deposited On: | 2015-10-07 |
Last Modified: | 2016-04-11 |
Downloads: | 115 View Download Statistics |
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