Right ventricular remodelling in pulmonary arterial hypertension with three-dimensional echocardiography: comparison with cardiac magnetic resonance imaging

Grapsa, Julia; O’Regan, Declan P; Pavlopoulos, Harry; Durighel, Giuliana; Dawson, David M.; Nihoyannopoulos, Petros

doi:10.1093/ejechocard/jep169

Cited by 118 publications

(98 citation statements)

References 29 publications

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“…124 In adults with PAH, good correlation was found in the calculation of RVEF and RVEDV determined by either 3D echocardiography or MRI measurements. 125 It was recently shown that adult patients with some forms of PH had more dilated, hypertrophied, and poorly functioning RVs than adults with other forms. 126 The use of 3D echocardiography has been validated for the measurement of RV volumes and EF, which correlated well with those variables determined by MRI imaging in a pediatric population.…”

Section: D Echocardiographymentioning

confidence: 99%

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

et al. 2016

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Transthoracic echocardiography (TTE) is the most accessible noninvasive diagnostic procedure for the initial assessment of pediatric pulmonary hypertension (PH). This review focuses on principles and use of TTE to determine morphologic and functional parameters that are also useful for follow-up investigations in pediatric PH patients. A basic echocardiographic study of a patient with PH commonly includes the hemodynamic calculation of the systolic pulmonary artery pressure (PAP), the mean and diastolic PAP, the pulmonary artery acceleration time, and the presence of a pericardial effusion. A more detailed TTE investigation of the right ventricle (RV) includes assessment of its size and function. RV function can be evaluated by RV longitudinal systolic performance (e.g., tricuspid annular plane systolic excursion), the tricuspid regurgitation velocity/right ventricular outflow tract velocity time integral ratio, the fractional area change, tissue Doppler imaging-derived parameters, strain measurements, the systolic-to-diastolic duration ratio, the myocardial performance (Tei) index, the RV/left ventricle (LV) diameter ratio, the LV eccentricity index, determination of an enlarged right atrium and RV size, and RV volume determination by 3-dimensional echocardiography. Here, we discuss the potential use and limitations of TTE techniques in children with PH and/or ventricular dysfunction. We suggest a protocol for TTE assessment of PH and myocardial function that helps to identify PH patients and their response to pharmacotherapy. The outlined protocol focuses on the detailed assessment of the hypertensive RV; RV-LV crosstalk must be analyzed separately in the evaluation of different pathologies that account for pediatric PH.

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Section: D Echocardiographymentioning

confidence: 99%

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

et al. 2016

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“…Relatively new and not fully explored areas include clinical significance of tricuspid plane motion dynamics [66,67], three-dimensional echocardiography of the right heart [26,75] and modern methods of local RV strain rate assessment [69,70]. While a few of them increase the quality of individual patient evaluation [68], others mostly prolong an already extensive list of measurements, which are currently being taken during a resting echocardiographic examination aimed at diagnosing, staging or following up PH.…”

Section: Future Directionsmentioning

confidence: 99%

The role of echocardiography in the diagnosis and management of patients with pulmonary hypertension

Habib¹,

Torbicki²

2010

Eur Respir Rev

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Pulmonary hypertension (PH) is defined as an increased mean pulmonary artery pressure (Ppa) .25 mmHg at rest as assessed by right heart catheterisation (RHC). However, this technique is invasive and noninvasive alternatives are desirable for early diagnosis of PH. Although estimation of systolic pulmonary arterial pressure is easily obtained using Doppler echocardiography, cases of under-and over-estimations are not rare and direct measurement of Ppa is not possible using this method. Therefore, echocardiography should be considered as a tool for assessment of the likelihood rather than the definite presence or absence of PH. Transthoracic echocardiography may be useful for noninvasive screening of patients at risk of PH. On the basis of an echocardiographic assessment, patients showing signs suggestive of PH can be referred for a confirmatory RHC. A number of variables measured during echocardiography reflect the morphological and functional consequences of PH and have prognostic value. The presence of pericardial effusion, reduced tricuspid annular plane excursion and right atrial enlargement are associated with a poorer prognosis. Echocardiography is also an important procedure for monitoring the response of patients to therapy, and is recommended 3-4 months after initiation of, or a change in, therapy. Echocardiographic assessment as part of a goal-oriented approach to therapy is essential for the effective management of PH patients.

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“…Indeed, although standard 2D transthoracic echocardiography has provided merely 3 potential treatment goals-preserved tricuspid annulus systolic excursion, normal right atrial area, and the absence of pericardial effusion-modern right heart echocardiography has potentially more to offer. [10][11][12][13][14][15][16][17][18][19][20] Of note, in their study, Ryo et al did not follow this direction but limited the assessment to rather rudimental estimation of RV volumes, simply expecting better precision of the measurements assisted by 3D wall motion tracking when compared with traditional 2D echocardiography. Similar to CMR, this still required manual tracing of endocardial and epicardial borders.…”

Section: See Article By Ryo Et Almentioning

confidence: 95%

Right Ventricle in Pulmonary Hypertension

Torbicki¹

2015

Circ: Cardiovascular Imaging

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Right ventricular remodelling in pulmonary arterial hypertension with three-dimensional echocardiography: comparison with cardiac magnetic resonance imaging

Abstract: RV remodelling in PAH patients can be accurately assessed with both 3DE and CMR. Both modalities are robust and reproducible with CMR being more reproducible for measurements of EF and RV mass.

Cited by 118 publications

References 29 publications

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

Transthoracic Echocardiography in the Evaluation of Pediatric Pulmonary Hypertension and Ventricular Dysfunction

The role of echocardiography in the diagnosis and management of patients with pulmonary hypertension

Right Ventricle in Pulmonary Hypertension

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