Right cardiac involvement in lung diseases: a multimodality approach from diagnosis to prognostication

Mandoli, Giulia Elena; Carli, Giuseppe De; Pastore, M C; Cameli, Paolo; Contorni, Francesco; d’Alessandro, Miriana; Bargagli, Elena; Mondillo, Sergio; Cameli, Matteo

doi:10.1111/joim.13179

Cited by 11 publications

(9 citation statements)

References 58 publications

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“…Thus, it remains a question when the other techniques are necessary, in order to detect more subtle changes in RV deformation, which might be present in patients with OSA. Novel echocardiographic techniques including 2DE and 3DE speckle tracking methods might therefore provide higher sensitivity in unmasking alterations in RV function and structure, in the early stages of RV dysfunction, when conventional echocardiographic methods cannot detect them [9,33,34]. These methods proved their utility in the assessment of RV function in acute conditions.…”

Section: Speckle Tracking Echocardiography In the Evaluation Of The Rmentioning

confidence: 99%

Understanding the role of echocardiography in patients with obstructive sleep apnea and right ventricular subclinical myocardial dysfunction – comparison with other conditions affecting RV deformation

et al. 2020

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Despite efforts to treat obstructive sleep apnea syndrome (OSA), the condition remains an important risk factor in the development of cardiovascular disease. Early detection of RV dysfunction with novel echocardiographic techniques (speckle tracking echocardiography) may be useful in preventing progression to pulmonary hypertension, with subsequent heart failure and cardiovascular death. Echocardiography is the method of choice for the evaluation of OSA consequences on the heart. Although standard echocardiographic parameters are routinely used in these patients, there are several limitations in the early detection of RV dysfunction. The main concerns are the complex geometry of RV and the impact of pre- and afterload on RV myocardium, which cannot be assessed through standard measurements. The aim of this review is to highlight the utility of advanced echocardiographic parameters in the identification of OSA patients with subclinical myocardial dysfunction, which are at risk of developing heart failure and later adverse events. Speckle tracking echocardiography might provide higher sensitivity in unmasking alterations in RV function when conventional echocardiographic methods cannot detect them. Therefore, this method has a major role in the detection of early stages of RV dysfunction, along with better risk stratification and better timing in the initiation of therapy.

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Section: Speckle Tracking Echocardiography In the Evaluation Of The Rmentioning

confidence: 99%

Understanding the role of echocardiography in patients with obstructive sleep apnea and right ventricular subclinical myocardial dysfunction – comparison with other conditions affecting RV deformation

et al. 2020

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“…[1][2][3] In COPD patients it has been found, that remodeling of the right ventricle already starts in early stages of COPD disease and even before the diagnosis of secondary pulmonary arterial alterations. 4 Right heart catheterization is recommended to diagnose and monitor secondary pulmonary hypertension if the results are expected to aid to management decisions. 5 The limitations of this technique in routine are its invasive nature, the need of special expertise and its application in patients where surgical treatment offers the only therapeutic option.…”

Section: Introductionmentioning

confidence: 99%

“…7,8 However, echocardiographic parameters measuring intrinsic pulmonary vascular abnormalities in COPD patients without pulmonary hypertension and its relation to cardiac ventricle performance in early stages are scarce. 4,9 The pulmonary pulse transit time (pPTT) is a promising noninvasive parameter of pulmonary vascular alterations and can be measured by transthoracic pulse wave Doppler echocardiography. 10 A decreased pPTT was shown in interstitial lung disease and fibrosis with precapillary pulmonary hypertension.…”

Section: Introductionmentioning

confidence: 99%

Doppler‐derived pulmonary pulse transit time measurements in chronic obstructive pulmonary disease: Reproducibility and cardiopulmonary function

Löffler,

Westhoff‐Bleck,

Welte

et al. 2024

Echocardiography

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IntroductionDoppler‐derived pulmonary pulse transit time (pPTT) is an auspicious hemodynamic marker in chronic pulmonary diseases. The aim is to compare four distinct pPTT measurements and its relation to right cardiac and pulmonary function.MethodsProspectively, 25 chronic obstructive pulmonary disease (COPD) patients (four patients excluded) and 32 healthy subjects underwent repeated distinct pPTT measurements, standard echocardiography, and pulmonary function testing on the same day. pPTT was defined as the interval from the R or Q‐wave in the electrocardiogram to the corresponding pulse wave Doppler peak late systolic (S) 2 or diastolic (D) pulmonary vein flow velocity (pPTT R‐S, Q‐S, R‐D, Q‐D). Reproducibility was assessed using Bland–Altman analysis, coefficient of variation (COV), intraclass correlation coefficient (ICC), and power calculations. Associations with right ventricular RV tissue and pulse wave Doppler velocities (RV E', RV S', RV A', RV E, RV A, RV E/E', RV E/A), TAPSE, right ventricular fractional area change, left ventricular systolic and diastolic function (LV ejection fraction, E, A, E/A, E/E', septal E', lateral E'), LA diameters, as well as forced expiratory volume in 1 s, forced vital capacity (FVC) predicted (%), and in liters were analyzed.ResultsThere was no significant difference and no bias between pPTT measures (p range: .1–.9). COV was in COPD 1.2%–2.3%, in healthy subjects 1.0%–3.1%. ICC ranged from .92 (COPD) to .96 (healthy subjects). In COPD significant correlations were found for pPTT R‐S, Q‐S and R‐D with RV E`, (all > ρ: .49, < p = .0364), pPTT R‐S, Q‐S with RV E/E` (both > ρ: .49, < p = .0291), pPTT Q‐S with RV S´ (ρ: .58, p = .0134), RV A (ρ: .59, p = .0339) and heart rate > ρ: −.39, < p = .0297). pPTT R‐S, R‐D showed significant correlations with FVC predicted (%) (ρ: .48 p = .0224) and FVC (l) (ρ:.47 p = .0347).ConclusionsAll pPTT measures exhibited high reproducibility. In COPD patients pPTT measures correlate with diastolic right ventricular function. Defining Q as starting point seems clinically advantageous considering electromechanical desynchrony in patients with conduction disorders.

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“…While some patients manifest no clinical evidence of heart disease, some others unveil cardiac manifestations such as myocarditis, myocardial infarction, asymptomatic cardiac arrhythmias, and atrioventricular block (2)(3)(4). Nevertheless, owing to mutual symptoms such as dyspnea, chest pain, and cough, diagnosis of cardiac involvement is usually problematic (5,6).…”

Section: Introductionmentioning

confidence: 99%

“…Cardiac biomarkers, electro-cardiogram, cardiac imaging such as echocardiogram, cardiovascular magnetic resonance, and computed tomography (CT) scan are of great concern to pinpoint the heart involvement. Amongst these tests, electrocardiography (ECG) is simple, widely available, and helpful (6).…”

Section: Introductionmentioning

confidence: 99%

ECG Prediction of Mortality in COVID-19 Patients by Sokolow-Lyon Voltage

et al. 2022

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Background: Different electrocardiographic (ECG) results, seen in coronavirus disease 2019 (COVID-19) patients are most likely due to the combined impact of acute COVID-19 and chronic heart disease. Few studies have addressed the effects of hypoxemia, the hallmark of the pandemic disease, on ECG. Objectives: The present study discusses the prevalence of arrhythmias and disorders of conduction system in demised and survived COVID-19 patients, using ECG and Sokolow-Lyon voltage as a sign of hypoxemia to predict mortality in the admitted patients and after discharge. Methods: We investigated the ECG, and other medical data of 960 COVID-19 patients admitted to Faghihi hospital in Shiraz, Iran, from August 2021 to December 2021. Results: Most of the patients were male (541 or 56.4%) and older than 65 years old (462 or 48.1%). A total of 475 (49.5%) patients died. Multiple logistic regression revealed an independent association between the COVID-19 death rate and cardiovascular disease (OR = 3.05; 95% CI: 1.96 - 4.74), QT dispersion more than 40 (OR = 5.08; 95% CI: 3.61 - 7.15), heart rate (more than 100 versus less than 60 OR = 2.86; 95% CI: 1.03 - 7.9), ST segment elevation myocardial infarction (OR = 3.93; 95% CI: 2.63 - 5.86), poor progression (OR = 2.33; 95% CI: 1.56 - 3.49), hypertrophy (OR = 1.97; 95% CI: 1.02 - 3.81), and Sokolow-Lyon (OR = 2.91; 95% CI: 1.64 - 5.16). Conclusions: Electrocardiographic examination of COVID-19 patients is important during admission and after discharge. Sokolow-Lyon voltage less than 10 can be regarded as an independent predictor of mortality in COVID-19 patients discharged from hospital.

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Right cardiac involvement in lung diseases: a multimodality approach from diagnosis to prognostication

Abstract: Right cardiac involvement in lung diseases: a multimodality approach from diagnosis to prognostication (Review).

Cited by 11 publications

References 58 publications

Understanding the role of echocardiography in patients with obstructive sleep apnea and right ventricular subclinical myocardial dysfunction – comparison with other conditions affecting RV deformation

Understanding the role of echocardiography in patients with obstructive sleep apnea and right ventricular subclinical myocardial dysfunction – comparison with other conditions affecting RV deformation

Doppler‐derived pulmonary pulse transit time measurements in chronic obstructive pulmonary disease: Reproducibility and cardiopulmonary function

ECG Prediction of Mortality in COVID-19 Patients by Sokolow-Lyon Voltage

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