Right ventricular dyssynchrony and its improvements after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Kanar, Batur Gönenç; Özben, Beste; Yıldırım, Elif; Özmen, İpek; Aydin, Rüya

doi:10.1111/echo.14019

Cited by 7 publications

(7 citation statements)

References 28 publications

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“…Some recent clinical studies have shown that an increase in the QRS duration interval-in other words, a disturbance in electrical conduction-is not necessarily required to cause RV EMD and RV mechanical dispersion because these have been detected in the failing myocardium with a normal QRS interval duration. [16][17][18][19][20] These findings are in accordance with our results but require further proof with larger studies.…”

Section: Discussionsupporting

confidence: 92%

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Assessment of right ventricular function and relation to mortality after acute pulmonary embolism: A speckle tracking echocardiography‐based study

et al. 2019

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Purpose Right ventricular (RV) dysfunction is a common condition that is related to increased adverse outcomes in patients with acute pulmonary embolism (APE). Our aim was to assess timing and magnitude of regional RV function using speckle tracking echocardiography (STE) and to evaluate their relationship to long‐term mortality in patients after APE. Methods In total, 147 patients were enrolled at the onset of an APE episode and followed for 12 ± 1.1 months. For all patients, the clinical, laboratory, and echocardiography examinations were performed at the diagnosis of APE and at the end of the 1‐year follow‐up. Results Of the 147 patients, 44 (29.9%) died during the 1‐year follow‐up after APE. The patients who died had lower RV free wall peak longitudinal systolic strains (PLSS) and left ventricular (LV) PLSS and higher RV peak systolic strain dispersion (PSSD) index which means the electromechanical dispersion when compared with the survivors. The difference in time to PLSS between the RV free wall and LV lateral wall (RVF–LVL) which means the electromechanical delay was longer in patients who died than in those who survived during follow‐up, and this difference was an independent predictor of mortality at 1 year of follow‐up after APE, with 86.4% sensitivity and 81.7% specificity. At the end of 1‐year follow‐up, the RV free wall PLSS and the LV global PLSS increased, whereas the RV PSSD index and the difference in time to PLSS between the RVF and LVL decreased. Conclusions Acute pulmonary embolism was associated with RV dysfunction and RV electromechanical delay and dispersion. These parameters improved at the end of 1‐year follow‐up. The electromechanical delay index might be a useful predictor of mortality in patients after APE.

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Section: Discussionsupporting

confidence: 92%

“…17 QRS interval duration. [16][17][18][19][20] These findings are in accordance with our results but require further proof with larger studies.…”

Section: Discussionsupporting

confidence: 92%

Assessment of right ventricular function and relation to mortality after acute pulmonary embolism: A speckle tracking echocardiography‐based study

et al. 2019

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“…It is important to emphasize that in the present study, RV electromechanical delay and dispersion were present even with a normal electrocardiographic QRS interval duration. A finding that is in agreement with previous data states that an abnormal electrical conduction is not necessarily needed to produce RV electromechanical delay and dispersion because it has been identified in the failing myocardium with a normal QRS duration (14, 21). Therefore, it appears that not all contributing mechanisms resulting in mechanical dispersion have been identified, and these mechanisms are probably complex.…”

Section: Discussionsupporting

confidence: 91%

Timing and Magnitude of Regional Right Ventricular Function and Their Relationship with Early Hospital Mortality in Patients with Acute Pulmonary Embolism

et al. 2019

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Objective: Right ventricular (RV) dysfunction in acute pulmonary embolism (APE) has been associated with increased mortality and morbidity. The aim of the present study was to assess the timing and magnitude of regional RV functions using speckle-tracking echocardiography (STE) and their relationship to early hospital mortality in patients with APE. Methods: One hundred forty-two patients were prospectively studied at the onset of an acute episode and after a median follow-up period of 30 days. Their clinical and laboratory characteristics were recorded. For all patients, conventional two-dimensional echocardiography and STE were performed within 24 h after the diagnosis of APE. Results: Twenty-eight (19.7%) patients died during the hospitalization follow-up. Patients who died during hospitalization were older and had higher high sensitivity cardiac troponin T levels, and a higher percentage of patients had simplified Pulmonary Embolism Severity Indexes. In STE analyses, they had lower RV free wall peak longitudinal systolic strain (PLSS) and higher RV peak systolic strain dispersion indexes. The time to PLSS difference between RV free wall and LV lateral was longer in patients who died during hospitalization than in those who survived, and this was an independent predictor of early hospital mortality with 85.7% sensitivity and 75.0% specificity in patients with APE. Conclusion: APE was associated with RV electromechanical delay and dispersion. Electromechanical delay index might be useful to predict early hospital mortality in patients with APE.

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“…Furthermore, a recent study has demonstrated that patients with COPD present intra-and interventricular dyssynchrony, and the difference between the time-to-peak longitudinal systolic strain of the RV free wall and the one of the lateral wall of the LV is an independent predictor of rehospitalization within one year [60]. Regarding RA alterations in this disease, RA volume index has been associated with both systolic and diastolic dysfunction in PH due to COPD and has shown correlations with laboratory markers of heart failure and cardiac remodelling, such as NT-pro-BNP and ssT2 [61]. Moreover, as its value increases, so does the long-term mortality rate [62,63].…”

Section: Chronic Obstructive Pulmonary Diseasementioning

confidence: 99%

Cor pulmonale: the role of traditional and advanced echocardiography in the acute and chronic settings

et al. 2020

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Cor pulmonale is the condition in which the right ventricle undergoes morphological and/or functional changes due to diseases that affect the lungs, the pulmonary circulation, or the breathing process. Depending on the speed of onset of the pathological condition and subsequent effects on the right ventricle, it is possible to distinguish the acute cor pulmonale from the chronic type of disease. Echocardiography plays a central role in the diagnostic and therapeutic work-up of these patients, because of its non-invasive nature and wide accessibility, providing its greatest usefulness in the acute setting. It also represents a valuable tool for tracking right ventricular function in patients with cor pulmonale, assessing its stability, deterioration, or improvement during follow-up. In fact, not only it provides parameters with prognostic value, but also it can be used to assess the efficacy of treatment. This review attempts to provide the current standards of an echocardiographic evaluation in both acute and chronic cor pulmonale, focusing also on the findings present in the most common pathologies causing this condition.

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Right ventricular dyssynchrony and its improvements after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Abstract: Chronic obstructive pulmonary disease was associated with intra- and interventricular dyssynchrony. PRP had an important impact on the improvement of both intra-, and interventricular dyssynchrony, which might be used in predicting hospitalization within 1 year.

Cited by 7 publications

References 28 publications

Assessment of right ventricular function and relation to mortality after acute pulmonary embolism: A speckle tracking echocardiography‐based study

Assessment of right ventricular function and relation to mortality after acute pulmonary embolism: A speckle tracking echocardiography‐based study

Timing and Magnitude of Regional Right Ventricular Function and Their Relationship with Early Hospital Mortality in Patients with Acute Pulmonary Embolism

Cor pulmonale: the role of traditional and advanced echocardiography in the acute and chronic settings

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