KMID : 0368120150450050398
|
|
Korean Circulation Journal 2015 Volume.45 No. 5 p.398 ~ p.407
|
|
Relationship between Right Ventricular Longitudinal Strain, Invasive Hemodynamics, and Functional Assessment in Pulmonary Arterial Hypertension
|
|
Park Jae-Hyeong
Kenya Kusunose Deborah H. Kwon Margaret M. Park Serpil C. Erzurum James D. Thomas Richard A. Grimm Brian P. Griffin Thomas H. Marwick Zoran B. Popovi?
|
|
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¡¾13 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¡¾5 vs. -12¡¾3%, p<0.01) and RV free wall (RVLSFW, -19¡¾5 vs. -14¡¾4%, 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¡¾13 to 46¡¾16 mmHg, p=0.03) and PVR (11¡¾5 to 6¡¾2 wood units, p<0.01) were significantly decreased with pulmonary vasodilator treatment. RVLSglobal (-12¡¾5 to -16¡¾5%, p<0.01) and RVLSFW (-14¡¾5 to -18¡¾5%, 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.
|
|
KEYWORD
|
|
Familial primary pulmonary hypertension, Heart ventricles, Ventricular function, right
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|