Right Ventricular Myocardial Work Characterization in Patients With Pulmonary Hypertension and Relation to Invasive Hemodynamic Parameters and Outcomes

Butcher, Steele C; Feloukidis, Christos; Kamperidis, Vasileios; Yedidya, Idit; Stassen, Jan; Fortuni, Federico; Vrana, Eleni; Mouratoglou, Sophia Anastasia; Boutou, Afroditi; Giannakoulas, George; Playford, David; Marsan, Nina Ajmone; Bax, Jeroen J.; Delgado, Victoria

doi:10.1016/j.amjcard.2022.04.058

Cited by 26 publications

(29 citation statements)

References 27 publications

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“…Butcher et al 97 demonstrated that RV GCW demonstrated a moderate correlation with invasively measured stroke volume and stroke volume index (r=0.63, P =0.002 and r=0.59, P =0.004) in 22 heart failure patients with reduced ejection fraction. In a follow-up study from the same group, Butcher et al 98 looked at the association of right ventricular myocardial work indices and all-cause mortality in 51 pulmonary hypertension patients and 21 patients with no structural heart disease. They showed that right ventricular GCW (HR, 1.42 per 100 mm Hg% <900 mm Hg% [95% CI, 1.12–1.81]; P =0.004) and right ventricular GWI (HR, 1.46 per 100 mm Hg% <650 mm Hg% [95% CI, 1.09–1.94], P =0.010) were associated with all-cause mortality, whereas conventional parameters of right ventricular function were not.…”

Section: Right Ventricular Myocardial Workmentioning

confidence: 99%

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confidence: 99%

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Myocardial Work in Echocardiography

Marzlin

Hays²,

Peters

et al. 2023

Circ: Cardiovascular Imaging

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Myocardial work is an emerging tool in echocardiography that incorporates left ventricular afterload into global longitudinal strain analysis. Myocardial work correlates with myocardial oxygen consumption, and work efficiency can also be assessed. Myocardial work has been evaluated in a variety of clinical conditions to assess the added value of myocardial work compared to left ventricular ejection fraction and global longitudinal strain. This review showcases the current use of myocardial work in adult echocardiography and its possible role in cardiac pathologies.

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Section: Right Ventricular Myocardial Workmentioning

confidence: 99%

mentioning

confidence: 99%

Myocardial Work in Echocardiography

Marzlin

Hays²,

Peters

et al. 2023

Circ: Cardiovascular Imaging

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“…Unlike RV longitudinal strain, TAPSE, and SF, RVMW parameters integrate contractility, RV desynchrony, and pulmonary pressures in the quantification. In addition, RVMW is not subject to the technical limitations of other standard RV systolic function parameters [28][29][30][31] . Patients were recruited from February 2018 to February 2020 in the present study, and there was no estimation of myocardial work.…”

Section: Discussionmentioning

confidence: 99%

Behavior of echocardiographic parameters of right ventricular function after tricuspid surgery

Torres

Quintero

Rodríguez

et al. 2022

Sci Rep

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Evaluation of right ventricular (RV) function after tricuspid valve surgery is complex. The objective was to identify the most appropriate RV function parameters for this purpose. This prospective study included 70 patients undergoing cardiac and tricuspid valve (TV) surgery. RV size and function parameters were determined at 3 months and 1-year post-surgery. Categorical variables were analyzed with the McNemar test and numerical variables with the Student’s t-test for related samples or, when non-normally distributed, the Wilcoxon test. Spearman's rho was used to determine correlations between variables at 3 months and 1 year. RV diameters were reduced at 3 months post-surgery and were then unchanged at 1 year. Tricuspid annular plane systolic excursion (TAPSE) and S′ wave values were worse at 3 months and then improved at 1 year (t-score-2.35, p 0.023; t-score-2.68; p 0.010). There was no significant reduction in free wall longitudinal strain (LS) or shortening fraction (SF) at 3 months (t-score 1.421 and − 1.251; p 0.218 and 0.172), and they were only slightly below pre-surgical values at 1 year. No relationship was found between RV function parameters and mortality or major complications. During the first few months after TV surgery, LS may be a more appropriate parameter to evaluate global ventricular function in comparison to TAPSE. At 1 year, good correlations are observed between TAPSE, S′ wave, and LS values.

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“…Butcher et al ( 23 ) also applied RV-PSL to assess RV function in a cohort of patients with heart failure with reduced left ventricular ejection fraction and found that RVGCW could reflect RV systolic function well and it correlated closely with invasively measured stroke volume and stroke volume index. Recently, Butcher et al reported that decreased values of RVGCW and RVGWI were associated with all-cause mortality in patients with PH ( 24 ). This is the first study that quantifies myocardial work through PSL method to evaluate cardiac function and predict clinical prognosis in patients with PH.…”

Section: Discussionmentioning

confidence: 99%

Apply pressure-strain loop to quantify myocardial work in pulmonary hypertension: A prospective cohort study

Wang

Chen

Yang

et al. 2022

Front. Cardiovasc. Med.

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ObjectivesPressure-strain loop (PSL) is a novel method to quantify myocardial work in many cardiovascular diseases. To investigate the value of myocardial work parameters derived from PSL for evaluating cardiac function and clinical prognosis in patients with pulmonary hypertension (PH).MethodsA total of 52 patients with PH and 27 healthy controls were enrolled in this prospective study. PSLs determined by echocardiography were used to calculate global work index (GWI) of left ventricle (LV) and right ventricle (RV). Global constructive work (GCW) comprised the sum of myocardial work performed during shortening in systole and during lengthening in isovolumic relaxation. Global wasted work (GWW) comprised the sum of myocardial work performed during lengthening in systole and during shortening in isovolumic relaxation. Global work efficiency (GWE) was defined as GCW/(GCW + GWW).ResultsLVGWW, RVGWI, RVGCW and RVGWW were significantly higher in patients than controls (all P < 0.001). LVGWE, LVGWI, LVGCW, and RVGWE were lower in patients than controls (all P < 0.01). Myocardial work parameters correlated well with clinical and other conventional echocardiographic assessments (all P < 0.05). In binary logistic regression analysis, the combination of RVGWE and estimation of pulmonary arterial systolic pressure (ePASP) was the best model to predict clinical outcomes (OR = 0.803, P = 0.002 and OR = 1.052, P = 0.015, respectively). Receiver operating characteristic curv demonstrated the combination of RVGWE and ePASP was the best predictor of adverse events with 100% sensitivity and 76.3% specificity (AUC = 0.910, P < 0.001).ConclusionMyocardial work parameters derived from PSL are emerging markers of cardiac function. And the combination of RVGWE and ePASP is a useful predictor of clinical outcome in PH patients.

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Right Ventricular Myocardial Work Characterization in Patients With Pulmonary Hypertension and Relation to Invasive Hemodynamic Parameters and Outcomes

Cited by 26 publications

References 27 publications

Myocardial Work in Echocardiography

Myocardial Work in Echocardiography

Behavior of echocardiographic parameters of right ventricular function after tricuspid surgery

Apply pressure-strain loop to quantify myocardial work in pulmonary hypertension: A prospective cohort study

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