Doppler echocardiographic index for assessment of global right ventricular function

Tei, Chuwa; Dujardin, Karl; Hodge, David O.; Bailey, Kent R.; McGoon, Michael D.; Tajik, A. Jamil; Seward, James B.

doi:10.1016/s0894-7317(96)90476-9

Cited by 871 publications

(648 citation statements)

References 16 publications

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“…However, the RV Tei indices were substantially higher than reported normal values [9], suggesting significant RV dysfunction despite normal RVEF. Thus, the Tei index, a measure of global cardiac function [9], might be a more sensitive parameter to estimate the RV dysfunction. Similar results were observed for the LV Tei index.…”

Section: Discussioncontrasting

confidence: 59%

The Impact of Beta-blockade on Right Ventricular Function in Mitral Regurgitation

Hongning

Stewart

Whalley

2014

Heart, Lung and Circulation

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IntroductionDegenerative mitral regurgitation (MR) results in left ventricular (LV) volume overload and LV dysfunction that contributes to prognosis [1]. RV function is also prognostically important [2]: tricuspid annular plane systolic excursion (TAPSE), a measure of systolic annular descent, is correlated with RV ejection fraction (RVEF) [3] and predicts survival after mitral valve repair [4].In patients with LV systolic dysfunction, beta-blockade improves prognosis [5] and reverses adverse LV remodelling [6], potentially mediated through a long-term reduction in myocyte strain, also seen with MR-related chronic LV volume overload [7]. Recently, we reported that short-term beta-blocker treatment did not change MR volume but decreased LV work in patients with moderate-severe MR [8]. The aim of this study was to investigate the influence of short-term beta-blocker on RV. Patients and MethodsThe methods have been reported elsewhere [8]. Briefly, patients with moderate-severe MR, normal LV systolic function (echo LV ejection fraction >55%) and sinus rhythm were recruited into this double-blind, randomised, crossover

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Section: Discussioncontrasting

confidence: 59%

The Impact of Beta-blockade on Right Ventricular Function in Mitral Regurgitation

Hongning

Stewart

Whalley

2014

Heart, Lung and Circulation

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“…46 The RIMP calculation is composed of RV isovolumetric contraction time, relaxation time, and ejection time, and the higher the value, the worse the RV function. 47,48 Importantly, RV function as estimated by echocardiography and pulmonary hemodynamics as measured by RHC (MPAP, CO, PVR) may independently characterize survival in PAH. 46,49 Our data suggest that the IPVD patients had better RV function (lower median RIMP) than non-IPVD patients at the time of diagnosis of POPH, despite similar hemodynamics.…”

Section: Discussionmentioning

confidence: 99%

Intrapulmonary vascular dilatations are common in portopulmonary hypertension and may be associated with decreased survival

et al. 2015

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MinnesotaHepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) are pulmonary vascular complications of portal hypertension with divergent clinicopathologic features and management. The presence of intrapulmonary vascular dilatations (IPVDs), detected by agitated saline contrast-enhanced transthoracic echocardiography (cTTE), is an essential feature of HPS but is not typically characteristic of POPH. Although IPVDs have been reported rarely in POPH, the prevalence and significance of this finding have not been systematically studied. We conducted a retrospective chart review of 80 consecutive patients diagnosed with POPH from January 1, 2002 to June 30, 2014 with documentation of cTTE findings, pulmonary hemodynamics, oxygenation, and survival. A total of 34 of the 80 patients (42%) underwent cTTE during initial diagnosis of POPH. IPVDs were detected in 20/34 patients (59%); intracardiac shunting was detected in 9/34 patients (26%; 4 also had IPVDs); and 9 patients (26%) had negative cTTE with no evidence of IPVD or intracardiac shunting. Patients with IPVD had decreased survival as compared to those without IPVD (P 5 0.003), a trend that persisted after exclusion of liver transplant recipients (P 5 0.07). The IPVD group had a trend toward higher Model for End-Stage Liver Disease score with and without incorporating sodium (MELD or MELD-Na; P 5 0.05 for both). The right ventricular index of myocardial performance (RIMP) was lower in the IPVD group (median, 0.4 versus 0.6; P 5 0.006). Patients with moderate or large IPVDs (n 5 6) had worse oxygenation parameters (partial pressure of arterial oxygen, diffusing capacity of the lung for carbon monoxide, and alveolar-arterial oxygen gradient) as compared to the rest of the cohort. Unexpectedly, IPVDs were frequently documented in POPH and associated with decreased survival. To further understand this observation, we recommend screening for IVPD in all patients with POPH. Liver Transpl 21:1355-1364, 2015. V C 2015 AASLD.Received March 25, 2015; accepted June 11, 2015. Abbreviations: A1AT, alpha-1-antitrypsin; A-a, alveolar-arterial; AIH, autoimmune hepatitis; ALD, alcoholic liver disease; ARDS, acute respiratory distress syndrome; ATN, acute tubular necrosis; CO, cardiac output; cTTE, contrast-enhanced transthoracic echocardiography; DLCO, diffusing capacity of the lung for carbon monoxide; DPG, diastolic pulmonary pressure gradient; ESLD, end-stage liver disease; HCC, hepatocellular carcinoma; HCV, hepatitis C virus; HPS, hepatopulmonary syndrome; INR, international normalized ratio; IPVD, intrapulmonary vascular dilatation; IQR, interquartile range; LT, liver transplantation; MELD, Model for End-Stage Liver Disease; MELD-Na, Model for End-Stage Liver Disease incorporating sodium; MPAP, mean pulmonary artery pressure; N/A, not available; Na, sodium; NASH, nonalcoholic steatohepatitis; PA, pulmonary artery; PAH, pulmonary arterial hypertension; PaO 2 , partial pressure of arterial oxygen; PCWP, pulmonary capillary wedge pressure; PEA, pulseless elect...

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“…Echocardiography generates many indices, and those with the best prognostic value identified by multivariate analysis are pericardial effusion [70,71], indexed right atrium area [71], LV eccentricity index [71] and the RV Doppler index [72,73]. Estimated systolic PAP derived from tricuspid regurgitant jet velocity is not prognostic [71].…”

Section: Clinical Echocardiographic and Haemodynamic Parametersmentioning

confidence: 99%

Guidelines for the diagnosis and treatment of pulmonary hypertension

Galiè¹,

Hoeper²,

Humbert³

et al. 2012

Revista Portuguesa de Cardiologia (English Edition)

419

738

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Doppler echocardiographic index for assessment of global right ventricular function

Cited by 871 publications

References 16 publications

The Impact of Beta-blockade on Right Ventricular Function in Mitral Regurgitation

The Impact of Beta-blockade on Right Ventricular Function in Mitral Regurgitation

Intrapulmonary vascular dilatations are common in portopulmonary hypertension and may be associated with decreased survival

Guidelines for the diagnosis and treatment of pulmonary hypertension

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