Right Ventricular Ejection Efficiency: A New Echocardiographic Measure of Mechanical Performance in Chronic Pulmonary Hypertension

Abstract

Based on these results, it appears that measurement of RVEe might be extremely useful for the assessment of RV mechanics and plasticity. The power curve relationship clearly demonstrates that minimal changes in PASP (up to 50 mmHg) result in dramatic reductions in RVEe. A steady decline in RVEe, though at a lower rate, continues to occur with increasing PASP. Additional studies are required using RVEe into a functional RV imaging algorithm and determine if RVEe correlates with development of symptoms, response to therapy and overall clinical outcomes.

Subclinical Right Ventricular Dysfunction in Patients with Severe Aortic Stenosis: A Retrospective Case Series

“…Furthermore, subclinical RV dysfunction has been identified as an adverse predictor of clinical outcomes in PH patients [8]. …”

Importance of End‐Diastolic Rather than End‐Systolic Right Atrial Size in Chronic Pulmonary Hypertension

“…Pulmonary arterial hypertension is a progressive disorder that mainly affects the pulmonary vasculature triggering a series of adaptative RV remodeling changes, based on the Laplace principle, in response to an increased RV afterload . Unfortunately, this initial adaptative RV remodeling eventually deteriorates into a maladaptative remodeling process where the enlarged and hypertrophied RV not only exhausts remodeling capabilities, but also is incapable of generating effective contractility that eventually is associated with RV failure and death . Consequently, right heart assessments remain critically important during routine treatment and management of cPH patients .…”

“…Chronic elevation in RV afterload triggers a series of anatomico‐functional responses, based on the Laplace principle, and clinically translated into progressive RV hypertrophy and dilatation . As a result, an enlarged and hypertrophied RV not only exhausts remodeling capabilities, but also is incapable of generating effective contractility . This gradual decline in RV systolic function has been identified as the main determinant of morbidity and mortality .…”

“…2 As a result, an enlarged and hypertrophied RV not only exhausts remodeling capabilities, but also is incapable of generating effective contractility. 3 This gradual decline in RV systolic function has been identified as the main determinant of morbidity and mortality. [4][5][6][7] Abnormal RV remodeling has also been implicated in worsening the severity of tricuspid regurgitation, as a direct result of tricuspid annular dilation, known to result in right atrial (RA) enlargement.…”

Moderne bildgebende Verfahren im Management der pulmonalen Hypertonie

“…Die rechtsventrikuläre Ejektionseffizienz [20] spiegelt die rechtsventrikuläre Mechanik und Plastizität wieder und ist durch das Verhältnis zwischen der mittels TAPSE (tricuspid annular plain systolic excursion) erfassten rechtsventrikulären Funktion und dem echokardiographisch erfassten pulmonalen Gefäßwiderstand definiert. Diese Studie zeigte, dass die Ejektionseffizienz bereits bei einem leichten Anstieg des pulmonalen Drucks deutlich abnimmt.…”