Relationship between mean right atrial pressure and doppler parameters in patients with right ventricular infarction

Mattioli, Anna Vittoria; Castelli, Annadele; Mattioli, Giorgio

doi:10.1002/clc.4960231015

Cited by 9 publications

(5 citation statements)

References 21 publications

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“…Interestingly, in the present study, no independent association between significant renal impairment and estimated RA pressure was observed, suggesting that the association with RV dysfunction may not be mediated by increased central venous pressure. However, the estimation of right atrial pressure on echocardiography through the evaluation of the inferior vena cava diameter and collapsibility may correlate less closely with invasively derived right atrial pressure in patients with significant TR [ 26 ]. Furthermore, estimated RA pressure may change acutely with alterations in volume or clinical status, whereas RV dysfunction may more accurately identify patients who are exposed to the cumulative effects of chronically elevated central venous pressure.…”

Section: Discussionmentioning

confidence: 99%

Renal function in patients with significant tricuspid regurgitation: pathophysiological mechanisms and prognostic implications

et al. 2021

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Butcher SC, Fortuni F, Dietz MF, Prihadi EA, van der Bijl P, Ajmone Marsan N, et al. Renal function in patients with significant tricuspid regurgitation: pathophysiological mechanisms and prognostic implications. J Intern Med 2021;Background. The pathophysiological mechanisms linking tricuspid regurgitation (TR) and chronic kidney disease (CKD) remain unknown. This study aimed to determine which pathophysiological mechanisms related to TR are independently associated with renal dysfunction and to evaluate the impact of renal impairment on long-term prognosis in patients with significant (≥ moderate) secondary TR.Methods. A total of 1234 individuals (72 [IQR 63-78] years, 50% male) with significant secondary TR were followed up for the occurrence of all-cause mortality and the presence of significant renal impairment (eGFR of <60 mL min À1 1.73 m À2 ) at the time of baseline echocardiography.Results. Multivariable analysis demonstrated that severe right ventricular (RV) dysfunction (TAPSE < 14 mm) was independently associated with the presence of significant renal impairment (OR 1.49, 95% CI 1.11 to 1.99, P = 0.008). Worse renal function was associated with a significant reduction in survival at 1 and 5 years (85% vs. 87% vs. 68% vs. 58% at 1 year, and 72% vs. 64% vs. 39% vs. 19% at 5 years, for stage 1, 2, 3 and 4-5 CKD groups, respectively, P < 0.001). The presence of severe RV dysfunction was associated with reduced overall survival in stage 1-3 CKD groups, but not in stage 4-5 CKD groups.Conclusions. Of the pathophysiological mechanisms identified by echocardiography that are associated with significant secondary TR, only severe RV dysfunction was independently associated with the presence of significant renal impairment. In addition, worse renal function according to CKD group was associated with a significant reduction in survival.

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Section: Discussionmentioning

confidence: 99%

Renal function in patients with significant tricuspid regurgitation: pathophysiological mechanisms and prognostic implications

et al. 2021

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“…Echocardiography remains the main technique in assessing right ventricular function in children with CHD 2 . Systolic and diastolic right ventricular echocardiographic values have been validated against cardiac catheterisation data in the adult population, 4 – 8 but minimal data exist in the paediatric congenital heart population correlating echocardiographic variables of right ventricular function with cardiac catheterisation data. Even less data exist validating the newer echocardiographic techniques of tissue Doppler imaging and deformation analysis for assessing right ventricular function in the paediatric population.…”

Section: Discussionmentioning

confidence: 99%

“…Adult studies have shown relationships between various echocardiographic systolic and diastolic values with invasive haemodynamic measurements 4 5 In addition, the newer echocardiographic techniques of tissue Doppler imaging and deformation analysis have also been shown to correlate with catheterisation values of systolic and diastolic function in adult studies; 6 – 8 however, minimal data exist in children documenting correlations between catheterisation values of function with echocardiographic measurements of function 9 …”

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confidence: 99%

Echocardiographic right ventricular function correlations with cardiac catheterisation data in biventricular congenital heart patients

et al. 2017

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Catheterisation dP/dt did not correlate with echocardiographic measurements of right ventricular systolic function. Strain rate and tissue Doppler imaging analysis significantly correlated with right ventricular end-diastolic pressure. These values should be further studied to determine whether they may be used as an alternative method to estimate right ventricular end-diastolic pressure in this patient population.

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“…To assess this using POCUS, the hepatic veins represent a window of this physiologic principle. The identification of a dominant diastolic component can reliably identify elevated RAP (50 –52), whereas a retrograde systolic component is suggestive of, but not synonymous with, hemodynamically significant tricuspid regurgitation (53,54). Although the reproducibility of the assessment has been reported to be excellent (55), the use of concurrent electrocardiogram tracing to ensure the proper identification of the systolic and diastolic phases remains critical for accurate interpretation.…”

Section: Role Of Pocusmentioning

confidence: 99%

How to Determine Fluid Management Goals during Continuous Kidney Replacement Therapy in Patients with AKI: Focus on POCUS

2022

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The utilization of kidney replacement therapies (KRT) for fluid management of patients who are critically ill has significantly increased over the last years. Clinical studies have suggested that both fluid accumulation and high fluid removal rates are associated with adverse outcomes in the critically ill population receiving KRT. Importantly, the ideal indications and/or fluid management strategies that could favorably affect these patients are unknown; however, differentiating clinical scenarios in which effective fluid removal may provide benefit to the patient by avoiding congestive organ injury, compared with other settings in which this intervention may result in harm, is direly needed in the critical care nephrology field. In this review, we describe observational data related to fluid management with KRT, and examine the role of point-of-care ultrasonography as a potential tool that could provide physiologic insights to better individualize decisions related to fluid management through KRT.

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Relationship between mean right atrial pressure and doppler parameters in patients with right ventricular infarction

Abstract: SummaryBackground: The incidence of an inferior left ventricular infarction involving the right ventricle is very high, ranging from 14 to 84%. Isolated right ventricular infarction accounts for

Cited by 9 publications

References 21 publications

Renal function in patients with significant tricuspid regurgitation: pathophysiological mechanisms and prognostic implications

Renal function in patients with significant tricuspid regurgitation: pathophysiological mechanisms and prognostic implications

Echocardiographic right ventricular function correlations with cardiac catheterisation data in biventricular congenital heart patients

How to Determine Fluid Management Goals during Continuous Kidney Replacement Therapy in Patients with AKI: Focus on POCUS

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