Assessment of the Right Ventricle by Echocardiography: A Primer for Cardiac Sonographers

Echocardiographic and Hemodynamic Predictors of Survival in Precapillary Pulmonary Hypertension

“…CI indicates cardiac index; CTEPH, chronic thromboembolic pulmonary hypertension; E/A ratio, mitral inflow ratio; EID, left ventricular eccentricity index in end diastole; EIS, left ventricular eccentricity index in end systole; FAC, fractional area change; HR, hazard ratio; IVC, inferior vena cava; IVRT, isovolumic relaxation time; LA, left atrial; MPI, myocardial performance index; PA, pulmonary artery; PASP, pulmonary arterial systolic pressure; PEf, pericardial effusion; PVR, pulmonary vascular resistance; RA, right atrial; RAP, RA pressure; RV, right ventricular estimation (composite score of function); RVOT AT, RV outflow tract acceleration time; RVSP, RV systolic pressure; TAPSE, tricuspid annular plane systolic excursion; and TR, tricuspid regurgitant. by guest on May 11, 2018 http://circimaging.ahajournals.org/…”

“…13,16,22 This may reflect the extent of left ventricular geometric deformation with RV pressure overload, because of ventricular interdependence. 24 In our cohort, eccentricity index was predictive of survival (unadjusted hazard ratio , 4.145 for the index in end diastole) in the univariable model but not in the multivariable model.…”

“…All echoes were analyzed by an observer blinded to the clinical history and patients outcomes. A range of echocardiographic parameters [15][16][17][18][19][20][21][22][23][24][25] was measured by 1 observer (J.G.). Intraobserver variability was assessed for all echocardiographic parameters on a 100 patients randomly sampled from the population.…”

“…[3][4][5][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] All patients also underwent left and right heart catheterization. Diagnostic criteria for precapillary PH were based on the current European guidelines, 1 which included a combination of invasive hemodynamic measures (mean pulmonary arterial pressure of ≥25 mm Hg at rest, pulmonary arterial wedge pressure ≤15 mm Hg and pulmonary vascular resistance (PVR)>3 Wood units) 1,2 and echocardiographic parameters such as tricuspid regurgitant (TR) velocity >2.6 m/s for patients below the age of 60 years or >2.9 m/s when older than 60 years or >2.8 m/s in obese patients (body mass index >30).…”

Should thrombolysis have a greater role in the management of pulmonary embolism?

“…There are also numerous more modalities available that allow the right ventricle to be more accurately assessed. 10 These include 3D echocardiography, tissue Doppler and strain imaging. However, these modalities will not be routinely used in most nonresearch centres as yet.…”