Impaired Global Right Ventricular Longitudinal Strain Predicts Long-Term Adverse Outcomes in Patients with Pulmonary Arterial Hypertension

Park, Jae‐Hyeong; Park, Margaret M.; Farha, Samar; Sharp, Jacqueline; Lundgrin, Erika L.; Comhair, Suzy; Tang, W.H. Wilson; Erzurum, Serpil C.; Thomas, James D.

doi:10.4250/jcu.2015.23.2.91

Cited by 64 publications

(61 citation statements)

References 28 publications

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“…Puwanant et al reported that the longitudinal deformation of RV free wall in patients with PH is significantly decreased compared to control subjects. Park et al reported that RVLS using echocardiographic velocity vector imaging significantly correlated with conventional echocardiographic RV function parameters. In this study, RVLS assessed with CMR‐HDA positively correlated with RVEDV and RVESV, whereas RVLS was inversely correlated with RVEF and RVCI in patients with CTEPH.…”

Section: Discussionmentioning

confidence: 99%

“…Strain, defined as tissue deformation as the myocardium contracts in systole as a result of sarcomere shortening as measured with echocardiography or CMR, now have been directly assess ventricular mechanics and function. Although the impaired right ventricular longitudinal strain (RVLS) measured with 2‐dimensional strain echocardiography was significantly associated with adverse clinical events and deaths in patients with pulmonary hypertension (PH), tissue character such myocardial edema, fibrosis cannot be obtained by echocardiography at the same time. CMR Myocardial tagging has been established as the standard of reference for accurate measurement of regional ventricular strain and both left and RV strain reduced in patients with PH, however, CMR tagging requires special scanning and post processing.…”

Section: Introductionmentioning

confidence: 99%

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CMR‐based heart deformation analysis for quantification of hemodynamics and right ventricular dysfunction in patients with CTEPH

Tao

Liu

et al. 2020

Clinical Respiratory J

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Introduction Quantification of hemodynamics and right ventricular (RV) function is crucial for pulmonary hypertension (PH). Cardiovascular magnetic resonance–based heart deformation analysis (CMR‐HDA) has been used to assess the ventricular strain. Objective This study was to determine the correlation of right ventricular longitudinal strain (RVLS) assessed with CMR‐HDA with RV function as well as hemodynamics in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods Thirty‐six CTEPH patients were prospectively included in this research. Each patients underwent CMR and right heart catheterization (RHC). RVLS and RV ejection fraction (RVEF) was quantified from cine images acquired with a retrospectively gated turbo FLASH gradient‐echo sequence. The late gadolinium enhancement (LGE) images were acquired using a 2D inversion recovery phase‐sensitive fast gradient‐echo sequence. Hemodynamics were determined with RHC. Results Right ventricular longitudinal strain measured with CMR‐HDA was −13.99 ± 4.94%. Bland–Altman plots showed statistical agreement with RVLS with low intra‐ and interobserver variability. RVLS correlated with serum N‐terminal‐pro‐B‐type natriuretic peptide (r = 0.615, P < .001). RVLS inversely correlated with RVEF (r = −0.699, P < .001), and it was positively correlated with both RVESV (r = 0.664, P < .001) and myocardial the volume of LGE (r = 0.447, P = .008). Receiver‐operating characteristic (ROC) indicated that RVLS values of >−14.20% could be used to predict RVEF <40% with a 100% sensitivity and a 96.7% specificity. Hemodynamically, RVLS was positively correlated with mean pulmonary artery pressure (r = 0.598, P < .001) and pulmonary vascular resistance (r = 0.685, P < .001). Conclusion Right ventricular longitudinal strain assessed by CMR‐HDA is a readily available and reproducible parameters of RV function. RVLS >−14.20% suggests the presence of RV dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CMR‐based heart deformation analysis for quantification of hemodynamics and right ventricular dysfunction in patients with CTEPH

Tao

Liu

et al. 2020

Clinical Respiratory J

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“…Beyond the additional value in left heart failure and valvular heart disease, RV plays a pivotal role in the regulation and compliance of the pulmonary vascular system [18,19] With exercise, RV dysfunction results in the increase of vascular pressures and impairment of oxygen exchange. However, studies focusing on RV function and functional capacity in apparently healthy subjects remain lacking.…”

Section: Discussionmentioning

confidence: 99%

The association between right ventricular free wall strain and exercise capacity for health check-up subjects

Chang¹,

Liu²,

Liu³

et al. 2017

PLoS ONE

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BackgroundRight ventricular (RV) function has been found to be a major factor of exercise capacity in patients with heart failure. However, the role of RV function in exercise capacity in healthy subjects has not been well studied. This study aims to validate the role of RV strain derived from speckle tracking echocardiography for exercise capacity for health check-up subjects.MethodsThis study prospectively recruited subjects from a routine health examination. All of them were symptom free. RV function represented by RV strain was derived from speckle tracking echocardiography in addition to traditional echocardiography parameters. Functional capacity was determined by a symptom limited treadmill exercise test with the Bruce protocol.ResultsAmong 164 recruited subjects (age 52.2 ±9.2 years, 66.4% male), 32 subjects represented impaired functional capacity (MET<8), which was significantly correlated with age, left ventricular mass index, left ventricular filling pressure (E/e’), global longitudinal strain of the left ventricle (LVGLS) (-16.0±2.5% vs. -18.9±3.8%, p < 0.001) and RV free wall strain (RVLS_FW) (-17.0±4.9% vs. -21.9±3.2%, p <0.001). After multivariate logistic regression, RVS_FW was an independent predictor for impaired functional capacity (OR 1.62, CI 1.32–1.98; p <0.001).ConclusionsIn conclusion, RV strain is independently associated with exercise capacity for health check-up subjects. RV function is an important factor for functional capacity.

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“…Severe BPD may result in chronic pulmonary artery hypertension (PAH) and gradual dilatation as well as hypertrophy of the right ventricle (RV)1)2)3)4)5) that can lead to RV dysfunction and right heart failure. It is associated with poor prognosis 3)4)5)6)7)8)…”

Section: Introductionmentioning

confidence: 99%

Clinical Utility of Echocardiography for the Diagnosis and Prognosis in Children with Bronchopulmonary Dsyplasia

Choi

Cho

Song

et al. 2016

J Cardiovasc Ultrasound

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BackgroundBronchopulmonary dysplasia (BPD) may result in chronic pulmonary artery hypertension and right ventricular (RV) dysfunction. Various echocardiographic assessments of RV dysfunction have been used to determine whether echocardiographic measurements of premature infants with BPD could provide sensitive measures of RV function that correlates with BPD severity.MethodsTwenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderate BPD, and six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspid regurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and tissue Doppler imaging (TDI) measurements. BPD severity was classified by the NICHD/NHLBI/ORD workshop rating scale. Twenty-eight control subjects without BPD (non BPD group), 28 patients with mild BPD, 11 patients with moderate BPD, and six patients with severe BPD underwent echocardiograms with standard measurement such as ejection fraction by M-mode, tricuspid regurgitation pressure gradient, myocardial performance index (MPI) derived from pulse Doppler, and TDI measurements. BPD severity was classified by the NICHD/NHLBI/ORD workshop rating scale.ResultsNone of the standard echocardiographic findings was significantly different between the control group and BPD groups. However, mean septal TDI-MPI of the severe BPD group (0.68 ± 0.06) was significantly (p < 0.01) higher than that of the non-BPD (0.58 ± 0.10) or the mild BPD group (0.59 ± 0.12). In addition, mean RV TDI-MPI of the severe BPD group (0.71 ± 0.13) was significantly (p < 0.05) higher than that of the non-BPD group (0.56 ± 0.08) or the mild BPD group (0.60 ± 0.125). Linear regression showed a good correlation between the severity of BPD and RV TDI-MPI (p = 0.01, R = 0.30) or septal TDI-MPI (p = 0.04, R = 0.24).ConclusionEchocardiographic evaluation of RV function based on an assessment of RV TDI-MPI can provide RV dysfunction parameter in premature infants with BPD.

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Impaired Global Right Ventricular Longitudinal Strain Predicts Long-Term Adverse Outcomes in Patients with Pulmonary Arterial Hypertension

Cited by 64 publications

References 28 publications

CMR‐based heart deformation analysis for quantification of hemodynamics and right ventricular dysfunction in patients with CTEPH

CMR‐based heart deformation analysis for quantification of hemodynamics and right ventricular dysfunction in patients with CTEPH

The association between right ventricular free wall strain and exercise capacity for health check-up subjects

Clinical Utility of Echocardiography for the Diagnosis and Prognosis in Children with Bronchopulmonary Dsyplasia

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