101
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Quantification of tricuspid regurgitation using two-dimensional velocity encoding cine: optimal plane and reproducibility. Int J Cardiovasc Imaging 2015. [DOI: 10.1007/s10554-015-0715-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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102
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Mahjoub Y, Malaquin S, Mourier G, Lorne E, Abou Arab O, Massy ZA, Dupont H, Ducancel F. Short- versus Long-Sarafotoxins: Two Structurally Related Snake Toxins with Very Different in vivo Haemodynamic Effects. PLoS One 2015; 10:e0132864. [PMID: 26176218 PMCID: PMC4503772 DOI: 10.1371/journal.pone.0132864] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 06/19/2015] [Indexed: 11/24/2022] Open
Abstract
Sarafotoxin-m (24 amino acids) from the venom of Atractaspis microlepidota microlepidota was the first long-sarafotoxin to be identified, while sarafotoxin-b (21 aa) is a short-sarafotoxin from Atractaspis engaddensis. Despite the presence of three additional C-terminus residues in sarafotoxin-m, these two peptides display a high sequence homology and share similar three-dimensional structures. However, unlike sarafotoxin-b, sarafotoxin-m shows a very low in vitro affinity for endothelin receptors, but still has a very high in vivo toxicity in mammals, similar to that of sarafotoxin-b. We have previously demonstrated, in vitro, the crucial role of the C-terminus extension in terms of pharmacological profiles and receptor affinities of long- versus short-sarafotoxins. One possible hypothesis to explain the high in vivo toxicity of sarafotoxin-m could be that its C-terminus extension is processed in vivo, resulting in short-like sarafotoxin. To address this possibility, we investigated, in the present study, the in vivo cardiovascular effects of sarafotoxin-b, sarafotoxin-m and sarafotoxin-m−Cter (sarafotoxin-m without the C -terminus extension). Male Wistar rats were anaesthetised and mechanically ventilated. Invasive haemodynamic measurements and echocardiographic measurements of left and right ventricular function were performed. The rats were divided into four groups that respectively received intravenous injections of: saline, sarafotoxin-b (one LD50), sarafotoxin-m (one LD50) or sarafotoxin-m−Cter (one LD50). All measurements were performed at baseline, at 1 minute (+1) and at 6 minutes (+6) after injection. Results: Sarafotoxin-b and sarafotoxin-m-Cter decreased cardiac output and impaired left ventricle systolic and diastolic function, whilst sarafotoxin-m decreased cardiac output, increased airway pressures and led to acute right ventricular dilatation associated with a decreased tricuspid annulus peak systolic velocity. Sarafotoxin-b and sarafotoxin-m−Cter appear to exert toxic effects via impairment of left ventricular function, whilst sarafotoxin-m increases airway pressures and impairs right ventricular function. These results do not support the hypothesis of an in vivo processing of long sarafotoxins.
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Affiliation(s)
- Yazine Mahjoub
- Pôle d’anesthésie, réanimation et médecine d’urgence, CHU Amiens, Amiens, France
- Unité INSERM U1088, Amiens, France
- * E-mail:
| | - Stéphanie Malaquin
- Pôle d’anesthésie, réanimation et médecine d’urgence, CHU Amiens, Amiens, France
- Unité INSERM U1088, Amiens, France
| | - Gilles Mourier
- CEA, iBiTec-S, Service d’Ingénierie Moléculaire des Protéines (SIMOPRO), CEA Saclay, F-91191 Gif sur Yvette, France
| | - Emmanuel Lorne
- Pôle d’anesthésie, réanimation et médecine d’urgence, CHU Amiens, Amiens, France
- Unité INSERM U1088, Amiens, France
| | - Osama Abou Arab
- Pôle d’anesthésie, réanimation et médecine d’urgence, CHU Amiens, Amiens, France
- Unité INSERM U1088, Amiens, France
| | | | - Hervé Dupont
- Pôle d’anesthésie, réanimation et médecine d’urgence, CHU Amiens, Amiens, France
- Unité INSERM U1088, Amiens, France
| | - Frédéric Ducancel
- CEA, iMETI, Service d’Immuno Virologie (SIV), CEA Fontenay-aux-Roses, F-92265 Fontenay-aux-Roses, France
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103
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Left ventricular remodeling in patients with sickle cell disease: determinants factors and impact on outcome. Ann Hematol 2015; 94:1621-9. [PMID: 26122867 DOI: 10.1007/s00277-015-2430-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 06/09/2015] [Indexed: 02/02/2023]
Abstract
Cardiovascular complications have been increasingly detected as a result of prolonged longevity of patients with sickle cell disease (SCD). Previous studies have focused especially on pulmonary hypertension and its consequences on the right-side heart chambers, whereas factors associated with morphological changes in left ventricle (LV) remain poorly understood. This study was designed to identify clinical, laboratorial, and echocardiographic parameters associated with LV remodeling and its impact on outcome in SCD. Ninety patients aged 28 ± 7 years and 20 age- and gender-balanced healthy subjects were enrolled. Laboratory tests, electrocardiogram, and an echocardiogram with tissue Doppler imaging were performed in all patients. Patients with SCD had larger left and right heart chambers dimensions, LV mass, and tricuspid regurgitation (TR) velocity compared to health controls with similar demographic features. Despite chambers enlargement, systolic function of both ventricles was preserved. The mitral inflow velocities were higher in the patients than in controls, whereas septal and lateral annular motion velocities were normal, suggesting normal ventricular relaxation. SCD patients who were on hydroxyurea therapy and/or hypertransfusion had higher hemoglobin concentrations, but similar echocardiographic findings in comparison to those without treatment. Systolic blood pressure, ferritin concentration, TR velocity, and parameters of diastolic function were independently associated with increased LV mass. In addition, the predictors of adverse events were ferritin concentration, lactate dehydrogenase levels, and TR velocity. LV remodeling in SCD patients seems to be influenced by a combination of factors including blood pressure, ferritin concentration, TR velocity, and parameters of LV diastolic function, and was not associated with adverse outcomes.
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104
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Lange SA, Jung J, Jaeck A, Hitschold T, Ebner B. Subclinical Myocardial Impairment Occurred in Septal and Anterior LV Wall Segments After Anthracycline-Embedded Chemotherapy and did not Worsen During Adjuvant Trastuzumab Treatment in Breast Cancer Patients. Cardiovasc Toxicol 2015; 16:193-206. [DOI: 10.1007/s12012-015-9328-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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105
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Harrison A, Hatton N, Ryan JJ. The right ventricle under pressure: evaluating the adaptive and maladaptive changes in the right ventricle in pulmonary arterial hypertension using echocardiography (2013 Grover Conference series). Pulm Circ 2015; 5:29-47. [PMID: 25992269 DOI: 10.1086/679699] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 08/19/2014] [Indexed: 01/02/2023] Open
Abstract
The importance of the right ventricle (RV) in pulmonary arterial hypertension (PAH) has been gaining increased recognition. This has included a reconceptualization of the RV as part of an RV-pulmonary circulation interrelated unit and the observation that RV function is a major determinant of prognosis in PAH. Noninvasive imaging of RV size and function is critical to the longitudinal management of patients with PAH, and continued understanding of the pathophysiology of pulmonary vascular disease relies on the response of the RV to pulmonary vascular remodeling. Echocardiography, in particular the newer echocardiographic measurements and techniques, allows easy, readily accessible means to assess and follow RV size and function.
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Affiliation(s)
- Alexis Harrison
- Division of Cardiovascular Medicine, Department of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Nathan Hatton
- Division of Pulmonary Medicine, Department of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - John J Ryan
- Division of Cardiovascular Medicine, Department of Medicine, University of Utah, Salt Lake City, Utah, USA
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106
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Dieden A, Gårdinger Y, Hlebowicz J, Björgell O, Dencker M. Effect of food intake on left and right ventricular systolic tissue Doppler measurements. Clin Physiol Funct Imaging 2015; 36:396-400. [PMID: 25976703 DOI: 10.1111/cpf.12242] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 01/27/2015] [Indexed: 11/27/2022]
Abstract
Systolic tissue Doppler measurements (s') have been used to measure the velocity in myocardial motion and are a valuable tool for evaluating the systolic function of the left and right ventricles. Digestion of food is known to significantly alter hemodynamics and may therefore affect s'. The effect of food intake on s' parameters has not yet been studied. We assessed whether s' is affected by food intake. Nineteen healthy subjects aged 26·2 ± 4·2 years were investigated. s' was measured with pulsed tissue Doppler imaging in the right and left ventricles before the subjects ate a standardized meal and also 30 and 110 min after the meal. Three measurements were taken in each projection, and a mean value was calculated for each. s' increased significantly (P<0·05) from fasting to 30 min after food intake in every measured site except in the left inferolateral wall (P = 0·15, NS). Several, but not all, variables returned to base value 110 min after food intake. This study shows that food intake affects the tissue Doppler variables used to evaluate systolic heart function. Further studies are needed in older healthy subjects and older subjects with various cardiovascular diseases.
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Affiliation(s)
- Anna Dieden
- Department of Clinical Sciences, Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ylva Gårdinger
- Department of Clinical Sciences, Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Joanna Hlebowicz
- Division of Medicine, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ola Björgell
- Department of Clinical Sciences, Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Magnus Dencker
- Department of Clinical Sciences, Department of Medical Imaging and Physiology, Skåne University Hospital, Lund University, Malmö, Sweden
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107
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Abstract
Transthoracic echocardiography is the most widely used imaging test in cardiology. Although completely noninvasive, transthoracic echocardiography has a well-established role in the diagnosis of numerous cardiovascular diseases, and also provides critical qualitative and quantitative information on their prognosis and pathophysiological processes. The aim of this Review is to outline the broad principles of transthoracic echocardiography, including the traditional techniques of two-dimensional, colour, and spectral Doppler echocardiography, and newly developed advances including tissue Doppler, myocardial deformation imaging, torsion, stress echocardiography, contrast and three-dimensional echocardiography. The advantages and disadvantages, clinical application, prognostic value, and salient research findings of each modality are described. Advances in complex imaging techniques are expected to continue unabated, and this Review highlights technical improvements that will influence the diagnosis and improve our understanding of cardiovascular function and disease.
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Affiliation(s)
- Anita C Boyd
- South Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Corner Elizabeth/Goulburn Street, NSW 2170, Australia
| | - Nelson B Schiller
- University of California, 505 Parnassus Avenue, San Francisco, CA 94143, USA
| | - Liza Thomas
- South Western Sydney Clinical School, University of New South Wales, Liverpool Hospital, Corner Elizabeth/Goulburn Street, NSW 2170, Australia
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108
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Egemnazarov B, Schmidt A, Crnkovic S, Sydykov A, Nagy BM, Kovacs G, Weissmann N, Olschewski H, Olschewski A, Kwapiszewska G, Marsh LM. Pressure Overload Creates Right Ventricular Diastolic Dysfunction in a Mouse Model: Assessment by Echocardiography. J Am Soc Echocardiogr 2015; 28:828-43. [PMID: 25840639 DOI: 10.1016/j.echo.2015.02.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Indexed: 10/23/2022]
Abstract
BACKGROUND Noninvasive diagnostic tools for right ventricular (RV) dysfunction measurements are increasingly being used, although their association with the pathologic mechanisms of dysfunction is poorly understood. Although investigations have focused mainly on RV systolic function, RV diastolic function remains mostly neglected. The aim of this study was to test which echocardiographic parameters best reflect RV diastolic function in mice. METHODS Pulmonary artery banding (PAB) was used to induce RV pressure overload in mice. Transthoracic echocardiography and invasive hemodynamic measurements were performed after 3 weeks in PAB and sham-operated mice. Subsequently, the hearts were investigated by histology and analyzed for gene expression. RESULTS PAB-induced pressure overload (RV systolic pressure PAB 52.6 ± 11.8 mm Hg vs sham 27.0 ± 2.7 mm Hg) resulted in RV hypertrophy and remodeling, as reflected by increased Fulton index (PAB 0.37 ± 0.05 vs sham 0.25 ± 0.02, P = .001). Masson's trichrome staining revealed increased interstitial fibrosis (PAB 12.25 ± 3.12% vs sham 3.97 ± 1.58%, P = .002). This was associated with significant systolic RV dysfunction as demonstrated by reduced contractility index and diastolic dysfunction as demonstrated by end-diastolic pressure (PAB 2.66 ± 0.83 mm Hg vs sham 1.49 ± 0.50 mm Hg, P < .001) and τ (PAB 40.0 ± 16.1 msec vs sham 13.0 ± 3.5 msec, P < .001). Messenger ribonucleic acid expression of β-myosin heavy chain, atrial and brain natriuretic peptides, collagen family members was elevated, and the sarco/endoplasmic reticulum Ca(2+)-ATPase was decreased. Echocardiography revealed significant increases in RV free wall thickness and isovolumic relaxation time and a decrease in left ventricular eccentricity index, E', and tricuspid annular plane systolic excursion. Isovolumic relaxation time and E' were significantly correlated with end-diastolic pressure (rs = 0.511 and -0.451) and τ (rs = 0.739 and -0.445, respectively). Moreover, E' was negatively correlated with the degree of RV fibrosis (rs = -0.717). CONCLUSIONS Within 3 weeks, PAB causes pressure overload-induced RV hypertrophy and remodeling with compensated systolic and diastolic dysfunction in mice. RV free wall thickness, tricuspid annular plane systolic excursion, E', E/E' ratio, and isovolumic relaxation time appear to be the most reliable echocardiographic parameters for the assessment of RV dysfunction.
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Affiliation(s)
| | - Albrecht Schmidt
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Slaven Crnkovic
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Akylbek Sydykov
- University of Giessen and Marburg Lung Center, Excellence Cluster Cardio-Pulmonary System, Giessen, Germany
| | - Bence M Nagy
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Gabor Kovacs
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria; Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Norbert Weissmann
- University of Giessen and Marburg Lung Center, Excellence Cluster Cardio-Pulmonary System, Giessen, Germany
| | - Horst Olschewski
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Andrea Olschewski
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria; Experimental Anesthesiology, Department of Anesthesia and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Grazyna Kwapiszewska
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria; Experimental Anesthesiology, Department of Anesthesia and Intensive Care Medicine, Medical University of Graz, Graz, Austria
| | - Leigh M Marsh
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
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109
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Bossone E, Dellegrottaglie S, Patel S, Grunig E, D'Andrea A, Ferrara F, Gargiulo P, D'Alto M, Soricelli A, Cittadini A, Sanz J, Perrone-Filardi P, Rubenfire M. Multimodality Imaging in Pulmonary Hypertension. Can J Cardiol 2015; 31:440-59. [DOI: 10.1016/j.cjca.2015.02.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 02/16/2015] [Accepted: 02/16/2015] [Indexed: 01/25/2023] Open
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110
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Transatrial repair of tetralogy of fallot: midterm results. Indian J Thorac Cardiovasc Surg 2015. [DOI: 10.1007/s12055-014-0352-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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111
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Kadappu KK, Thomas L. Tissue Doppler Imaging in Echocardiography: Value and Limitations. Heart Lung Circ 2015; 24:224-33. [DOI: 10.1016/j.hlc.2014.10.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 10/15/2014] [Indexed: 10/24/2022]
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112
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Hayabuchi Y, Sakata M, Kagami S. Right ventricular myocardial deformation patterns in children with congenital heart disease associated with right ventricular pressure overload. Eur Heart J Cardiovasc Imaging 2015; 16:890-9. [DOI: 10.1093/ehjci/jev011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 01/19/2015] [Indexed: 11/12/2022] Open
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113
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Serial assessment of right ventricular function using tissue Doppler imaging in preterm infants within 7 days of life. Early Hum Dev 2015; 91:125-30. [PMID: 25617862 DOI: 10.1016/j.earlhumdev.2014.12.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 12/26/2014] [Accepted: 12/28/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND We aimed to evaluate right ventricular (RV) function longitudinally using tissue Doppler imaging (TDI) echocardiography in preterm infants. METHODS We selected 101 very-low-birth-weight (VLBW) infants for the study. Echocardiographic examinations including TDI were performed serially within 7days of life. Pulsed-Doppler TDI waveforms were recorded at the tricuspid valve annulus, and peak systolic velocities (Sa), early diastolic velocities (Ea), and late diastolic velocities (Aa) were measured. RESULTS Sa, Ea and Aa were all reduced significantly from 3h to 12h, and then increased gradually thereafter. These three velocities also increased with gestational age in the early neonatal period. The ratio of Ea to Aa (Ea/Aa) did not change significantly within the first week of life. The ratio of E to Ea (E/Ea) in VLBW infants also seemed to remain stable from birth to day 7. The values of Sa appeared to be associated with cardiac output in the early neonatal period. Both Sa and Aa in intubated infants were significantly higher than in non-intubated infants. CONCLUSION RV TDI velocities of preterm infants in the early neonatal period are influenced by gestational age, postnatal age, and respiratory status, although the RV E/Ea ratio appears to be almost stable throughout the neonatal period. Our findings may provide some basis for assessment of RV function in critically ill preterm infants.
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114
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Vizzardi E, Bonadei I, Sciatti E, Pezzali N, Farina D, D'Aloia A, Metra M. Quantitative analysis of right ventricular (RV) function with echocardiography in chronic heart failure with no or mild RV dysfunction: comparison with cardiac magnetic resonance imaging. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2015; 34:247-255. [PMID: 25614398 DOI: 10.7863/ultra.34.2.247] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES Right ventricular (RV) performance parameters (tricuspid annular plane systolic excursion, systolic longitudinal velocity on tissue Doppler imaging, fractional area change, and tissue and 2-dimensional [2D] strain on the right free wall) have been validated. In comparative studies, they have been correlated with the prognosis of patients with heart failure on radionuclide ventriculography and thermodilution in right heart catheterization. This study aimed to evaluate RV systolic function in patients with heart failure with no or mild RV dysfunction and correlate the above-mentioned echocardiographic parameters with the magnetic resonance imaging (MRI)-calculated RV ejection fraction (RVEF), stroke volume, end-diastolic volume, and end-systolic volume. METHODS Standard and pulsed Doppler tissue echocardiography and MRI were performed in 31 patients with New York Heart Association functional class II and III chronic heart failure. RESULTS A high correlation between tricuspid annular plane systolic excursion, systolic longitudinal velocity, tissue strain, and 2D strain was noted, whereas the fractional area change did not correlate with any other parameter. The RVEF correlated with tricuspid annular plane systolic excursion, systolic longitudinal velocity, and tissue and 2D strain (all P< .01); under linear regression analysis, the 4 parameters independently correlated with RVEF. CONCLUSIONS Echocardiographic RV performance parameters (tricuspid annular plane systolic excursion, systolic longitudinal velocity, tissue strain, and 2D strain) correlated with the MRI-calculated RVEF and overall predicted it. In particular, RV 2D strain and tissue strain were good markers for RV longitudinal motions. These echocardiographic parameters are easily obtained and may give important information about RV function for evaluation and prognostic stratification of patients with heart failure.
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Affiliation(s)
- Enrico Vizzardi
- Sections of Cardiovascular Disease (E.V., I.B., E.S., N.P., A.D., M.M.) and Radiology (D.F.), Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
| | - Ivano Bonadei
- Sections of Cardiovascular Disease (E.V., I.B., E.S., N.P., A.D., M.M.) and Radiology (D.F.), Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Edoardo Sciatti
- Sections of Cardiovascular Disease (E.V., I.B., E.S., N.P., A.D., M.M.) and Radiology (D.F.), Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Natalia Pezzali
- Sections of Cardiovascular Disease (E.V., I.B., E.S., N.P., A.D., M.M.) and Radiology (D.F.), Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Davide Farina
- Sections of Cardiovascular Disease (E.V., I.B., E.S., N.P., A.D., M.M.) and Radiology (D.F.), Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Antonio D'Aloia
- Sections of Cardiovascular Disease (E.V., I.B., E.S., N.P., A.D., M.M.) and Radiology (D.F.), Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Marco Metra
- Sections of Cardiovascular Disease (E.V., I.B., E.S., N.P., A.D., M.M.) and Radiology (D.F.), Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
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115
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Assessment of Ventricular-Vascular Function by Echocardiography. CONGENIT HEART DIS 2015. [DOI: 10.1007/978-4-431-54355-8_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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116
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Ji Q, Mei Y, Wang X, Feng J, Ding W. Risk Factors for Late Right Ventricular Systolic Dysfunction in Pediatric Patients With Repaired Tetralogy of Fallot. Int Heart J 2015; 56:80-5. [DOI: 10.1536/ihj.14-154] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Qiang Ji
- Department of Thoracic Cardiovascular Surgery of Tongji Hospital of Tongji University
| | - Yunqing Mei
- Department of Thoracic Cardiovascular Surgery of Tongji Hospital of Tongji University
| | - Xisheng Wang
- Department of Thoracic Cardiovascular Surgery of Tongji Hospital of Tongji University
| | - Jing Feng
- Department of Thoracic Cardiovascular Surgery of Tongji Hospital of Tongji University
| | - Wenjun Ding
- Department of Cardiovascular Surgery of Zhongshan Hospital of Fudan University
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117
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Right Ventricular Systolic Dysfunction Is Related to Exercise Intolerance in Patients With Chronic Obstructive Pulmonary Disease. J Cardiopulm Rehabil Prev 2015; 35:70-4. [DOI: 10.1097/hcr.0000000000000086] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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118
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Shiino K, Sugimoto K, Yamada A, Takada K, Kawai H, Sugimoto K, Takahashi H, Takagi Y, Iwase M, Ozaki Y. Usefulness of right ventricular basal free wall strain by two-dimensional speckle tracking echocardiography in patients with chronic thromboembolic pulmonary hypertension. Int Heart J 2014; 56:100-4. [PMID: 25742946 DOI: 10.1536/ihj.14-162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Recently two-dimensional (2D) speckle tracking echocardiography (STE) derived from right ventricular (RV) free wall has been shown to be a very useful tool for the estimation of RV performance. The purpose of this study was to examine whether RV basal free wall strain can detect increased mean pulmonary arterial pressure (mPAP) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We investigated a total of 126 patients with CTEPH (mean age, 56 ± 12 years). They underwent echocardiography and right heart catheter examination. 2D STE-derived longitudinal strain was measured by placing 2 regions of interests (ROIs) on the RV basal free wall in RV-focused apical 4-chamber view. Peak strain (RV-PS) was acquired between the 2 ROIs. Conventional echocardiographic RV parameters (RV fractional area change, RV myocardial performance index, tricuspid annular plane systolic excursion, tricuspid annular peak systolic velocity, and tricuspid regurgitant pressure gradient) were evaluated as well. Right heart catheterization was performed on the day following of echocardiographic evaluation. Among RV echo parameters, RV-PS showed the best correlation with mPAP (r = 0.75, P < 0.0001). Receiver operating characteristic analysis revealed that a cut-off value of RV-PS -20.8% could detect mPAP ≧ 25 mmHg (sensitivity 78%, specificity 93%, area under the curve 0.90, P < 0.001). RV basal free wall strain was a useful tool for the non-invasive detection of increased mPAP in patients with CTEPH.
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Affiliation(s)
- Kenji Shiino
- Department of Cardiology, Fujita Health University School of Medicine
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119
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Di Prima AL, Covello DR, Franco A, Gerli C, Lembo R, Denti P, Godino C, Taramasso M, Maisano F, Pappalardo F. Do Patients Undergoing MitraClip Implantation Require Routine ICU Admission? J Cardiothorac Vasc Anesth 2014; 28:1479-83. [DOI: 10.1053/j.jvca.2014.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Indexed: 11/11/2022]
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120
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Adel W, William V, Josef M, Al-Mahallawy N. Tissue Doppler systolic annular velocity and myocardial performance index as predictors of right ventricular affection and culprit lesion location in acute inferior myocardial infarction. Egypt Heart J 2014. [DOI: 10.1016/j.ehj.2014.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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121
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Darahim KE. Right ventricular systolic echocardiographic parameters in chronic systolic heart failure and prognosis. Egypt Heart J 2014. [DOI: 10.1016/j.ehj.2013.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Echocardiographic assessment of global longitudinal right ventricular function in patients with an acute inferior ST elevation myocardial infarction and proximal right coronary artery occlusion. Int J Cardiovasc Imaging 2014; 31:497-507. [DOI: 10.1007/s10554-014-0573-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 11/11/2014] [Indexed: 10/24/2022]
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123
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Patel A, Weismann C, Weiss P, Russell K, Bazzy-Asaad A, Kadan-Lottick NS. Association between right ventricular dysfunction and restrictive lung disease in childhood cancer survivors as measured by quantitative echocardiography. Pediatr Blood Cancer 2014; 61:2059-64. [PMID: 25130668 DOI: 10.1002/pbc.25157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 05/19/2014] [Indexed: 11/12/2022]
Abstract
BACKGROUND Restrictive lung disease is a complication in childhood cancer survivors who received lung-toxic chemotherapy and/or thoracic radiation. Left ventricular dysfunction is documented in these survivors, but less is known about right ventricular (RV) function. Quantitative echocardiography may help detect subclinical RV dysfunction. The aim of this study was to assess RV function quantitatively in childhood cancer survivors after lung-toxic therapy. PROCEDURES We identified records of 33 childhood cancer survivors who (1) were treated with lung-toxic therapy and/or radiation, (2) were cancer-free for ≥ one year after therapy, and (3) had pulmonary function tests and echocardiograms from their most recent follow-up visit. RESULTS Participants' mean age was 11.6 ± 4.5 years at cancer diagnosis and 23 ± 8.6 years at evaluation. The most common diagnosis was lymphoma/leukemia (n = 27). Twenty-nine subjects had anthracycline exposure. Eleven of the 33 subjects demonstrated restrictive pulmonary impairment (total lung capacity 3.69 ± 1.5 L [69.3 ± 22.4% predicted]). Among quantitative measures of RV function, isovolumetric acceleration (IVA), a measure of contractility, was significantly lower in the group with restrictive lung disease (2.42 ± 0.56 vs. 1.83 ± 0.78 m/sec(2); P < 0.05). There was a trend towards lower tissue Doppler derived S' and tricuspid annular plane systolic excursion in the group with restrictive lung disease. Subjects with restrictive lung disease were found to have ≥ 2 abnormal parameters (P < 0.01). CONCLUSION IVA may detect early RV dysfunction in childhood cancer survivors with restrictive lung disease. Our findings require confirmation in a larger study population and validation by cardiac MRI.
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Affiliation(s)
- Amee Patel
- Section of Pediatric Respiratory Medicine, Yale University School of Medicine, New Haven, Connecticut
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124
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Prognostic role of transthoracic echocardiography in patients affected by heart failure and reduced ejection fraction. Heart Fail Rev 2014; 20:305-16. [DOI: 10.1007/s10741-014-9461-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Selcuk M, Sayar N, Demir S, Rodi Tosua A, Aslan V. The value of isovolumic acceleration for the assessment of right ventricular function in acute pulmonary embolism. Rev Port Cardiol 2014; 33:591-6. [PMID: 25300858 DOI: 10.1016/j.repc.2014.01.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 01/16/2014] [Accepted: 01/27/2014] [Indexed: 10/24/2022] Open
Abstract
AIM The aim of this study was to assess the value of tricuspid annulus myocardial isovolumic acceleration (IVA) in the assessment of right ventricular function in patients with acute pulmonary embolism (PE). METHODS Fifteen patients (mean age 60.6±11.3 years) with acute PE were enrolled and a control group was formed of 15 patients with a similar mean age (60.3±11.5). Patients who were diagnosed with acute PE by thoracic computed tomography angiography underwent transthoracic echocardiography at the time of diagnosis and at one month after diagnosis. RESULTS In the control group IVA was 2.8±0.2 m/s(2), while in the acute PE group, it was 2.0±0.1 m/s(2) at the time of diagnosis and 2.9±0.1 m/s(2) at the end of the first month. When IVA values of acute PE patients at the end of the first month were compared with their initial values and those of the control group, they had normalized (control and acute PE p<0.0001; control and PE at one-month follow-up p=0.983). CONCLUSION In our study, IVA was shown to be a reliable marker of right ventricular systolic function in patients with acute PE.
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Affiliation(s)
- Murat Selcuk
- Department of Cardiology, Van Education and Research Hospital, Van, Turkey
| | - Nurten Sayar
- Department of Cadiology, Siyami Ersek Education and Research Hospital, Istambul, Turkey
| | | | - Aydın Rodi Tosua
- Department of Cardiology, Van Education and Research Hospital, Van, Turkey
| | - Vedat Aslan
- Department of Cadiology, Siyami Ersek Education and Research Hospital, Istambul, Turkey
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Hu R, David Mazer C, Tousignant C. Relationship Between Tricuspid Annular Excursion and Velocity in Cardiac Surgical Patients. J Cardiothorac Vasc Anesth 2014; 28:1198-202. [DOI: 10.1053/j.jvca.2013.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Indexed: 11/11/2022]
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127
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Peyrou J, Parsaï C, Chauvel C, Simon M, Dehant P, Abergel E. Echocardiographic assessment of right ventricular systolic function in a population of unselected patients before cardiac surgery: A multiparametric approach is necessary. Arch Cardiovasc Dis 2014; 107:529-39. [DOI: 10.1016/j.acvd.2014.06.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 06/16/2014] [Accepted: 06/20/2014] [Indexed: 11/28/2022]
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128
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Selcuk M, Sayar N, Demir S, Rodi Tosua A, Aslan V. The value of isovolumic acceleration for the assessment of right ventricular function in acute pulmonary embolism. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2014. [DOI: 10.1016/j.repce.2014.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Pleister A, Kahwash R, Haas G, Ghio S, Cittadini A, Baliga RR. Echocardiography and Heart Failure: A Glimpse of the Right Heart. Echocardiography 2014; 32 Suppl 1:S95-107. [DOI: 10.1111/echo.12678] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Adam Pleister
- Division of Cardiovascular Medicine; The Ohio State University Wexner Medical Center; Columbus Ohio
| | - Rami Kahwash
- Division of Cardiovascular Medicine; The Ohio State University Wexner Medical Center; Columbus Ohio
| | - Garrie Haas
- Division of Cardiovascular Medicine; The Ohio State University Wexner Medical Center; Columbus Ohio
| | - Stefano Ghio
- Thoracic and Vascular Department; Fondazione IRCCS Policlinico San Matteo; Pavia Italy
| | - Antonio Cittadini
- Department of Translational Medical Sciences; Universityà Federico II; Napoli Italy
| | - Ragavendra R Baliga
- Division of Cardiovascular Medicine; The Ohio State University Wexner Medical Center; Columbus Ohio
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Limongelli G, Rea A, Masarone D, Francalanci MP, Anastasakis A, Calabro' R, Giovanna RM, Bossone E, Elliott PM, Pacileo G. Right ventricular cardiomyopathies: a multidisciplinary approach to diagnosis. Echocardiography 2014; 32 Suppl 1:S75-94. [PMID: 25234203 DOI: 10.1111/echo.12399] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The physiological importance of the right ventricle (RV) has been underestimated over the past years. Finally in the early 1950s through the 1970s, cardiac surgeons recognized the importance of RV function. Since then, the importance of RV function has been recognized in many acquired cardiac heart disease. RV can be mainly or together with left ventricle (LV) affected by inherited or acquired cardiomyopathy. In fact, RV morphological and functional remodeling occurs more common during cardiomyopathies than in ischemic cardiomyopathies and more closely parallels LV dysfunction. Moreover, there are some cardiomyopathy subtypes showing a predominant or exclusive involvement of the RV, and they are probably less known by cardiologists. The clinical approach to right ventricular cardiomyopathies is often challenging. Imaging is the first step to raise the suspicion and to guide the diagnostic process. In the differential diagnosis, cardiologists should consider athlete's heart, congenital heart diseases, multisystemic disorders, and inherited arrhythmias. However, a multiparametric and multidisciplinary approach, involving cardiologists, experts in imaging, geneticists, and pathologists with a specific expertise in these heart muscle disorders is required.
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Affiliation(s)
- Giuseppe Limongelli
- Division of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy
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131
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Evaluation of Right Ventricular Myocardial Function in Healthy Horses With Recurrent Airway Obstruction Using Tissue Doppler Imaging. J Equine Vet Sci 2014. [DOI: 10.1016/j.jevs.2014.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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de Alencar MCN, Rocha MODC, Lima MMDO, Costa HS, Sousa GR, Carneiro RDCB, Silva GCR, Brandão FV, Kreuser LJ, Ribeiro ALP, Nunes MCP. Heart rate recovery in asymptomatic patients with Chagas disease. PLoS One 2014; 9:e100753. [PMID: 24979699 PMCID: PMC4076274 DOI: 10.1371/journal.pone.0100753] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 05/28/2014] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Chagas disease patients with right bundle-branch block (RBBB) have diverse clinical presentation and prognosis, depending on left ventricular (LV) function. Autonomic disorder can be an early marker of heart involvement. The heart rate recovery (HRR) after exercise may identify autonomic dysfunction, with impact on therapeutic strategies. This study was designed to assess the HRR after symptom-limited exercise testing in asymptomatic Chagas disease patients with RBBB without ventricular dysfunction compared to patients with indeterminate form of Chagas disease and healthy controls. METHODS One hundred and forty-nine subjects divided into 3 groups were included. A control group was comprised of healthy individuals; group 1 included patients in the indeterminate form of Chagas disease; and group 2 included patients with complete RBBB with or without left anterior hemiblock, and normal ventricular systolic function. A symptom-limited exercise test was performed and heart rate (HR) response to exercise was assessed. HRR was defined as the difference between HR at peak exercise and 1 min following test termination. RESULTS There were no differences in heart-rate profile during exercise between healthy individuals and patients in indeterminate form, whereas patients with RBBB had more prevalence of chronotropic incompetence, lower exercise capacity and lower HRR compared with patients in indeterminate form and controls. A delayed decrease in the HR after exercise was found in 17 patients (15%), 9% in indeterminate form and 24% with RBBB, associated with older age, worse functional capacity, impaired chronotropic response, and ventricular arrhythmias during both exercise and recovery. By multivariable analysis, the independent predictors of a delayed decrease in the HRR were age (odds ratio [OR] 1.11; 95% confidence interval [CI] 1.03 to 1.21; p = 0.010) and presence of RBBB (OR 3.97; 95% CI 1.05 to 15.01; p = 0.042). CONCLUSIONS A small proportion (15%) of asymptomatic Chagas patients had attenuated HRR after exercise, being more prevalent in patients with RBBB compared with patients in indeterminate form and controls.
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Affiliation(s)
- Maria Clara Noman de Alencar
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Manoel Otávio da Costa Rocha
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Márcia Maria de Oliveira Lima
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Henrique Silveira Costa
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Giovane Rodrigo Sousa
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Renata de Carvalho Bicalho Carneiro
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Lucas Jordan Kreuser
- University of Minnesota Medical School, Minneapolis, Minnesota, United States of America
| | - Antonio Luiz Pinho Ribeiro
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maria Carmo Pereira Nunes
- Post-Graduate Program in Infectious Diseases and Tropical Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- * E-mail:
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Nguyen T, Cao L, Movahed A. Altered Right Ventricular Contractile Pattern after Cardiac Surgery: Monitoring of Septal Function Is Essential. Echocardiography 2014; 31:1159-65. [DOI: 10.1111/echo.12657] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Tin Nguyen
- Department of Cardiovascular Sciences; Brody School of Medicine; East Carolina Heart Institute; East Carolina University; Greenville North Carolina
| | - Long Cao
- Department of Cardiovascular Sciences; Brody School of Medicine; East Carolina Heart Institute; East Carolina University; Greenville North Carolina
| | - Assad Movahed
- Department of Cardiovascular Sciences; Brody School of Medicine; East Carolina Heart Institute; East Carolina University; Greenville North Carolina
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Uemura K, Inagaki M, Zheng C, Li M, Kawada T, Sugimachi M. A novel technique to predict pulmonary capillary wedge pressure utilizing central venous pressure and tissue Doppler tricuspid/mitral annular velocities. Heart Vessels 2014; 30:516-26. [PMID: 24879503 DOI: 10.1007/s00380-014-0525-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 05/09/2014] [Indexed: 11/28/2022]
Abstract
Assessing left ventricular (LV) filling pressure (pulmonary capillary wedge pressure, PCWP) is an important aspect in the care of patients with heart failure (HF). Physicians rely on right ventricular (RV) filling pressures such as central venous pressure (CVP) to predict PCWP, assuming concordance between CVP and PCWP. However, the use of this method is limited because discordance between CVP and PCWP is observed. We hypothesized that PCWP can be reliably predicted by CVP corrected by the relationship between RV and LV function, provided by the ratio of tissue Doppler peak systolic velocity of tricuspid annulus (S(T)) to that of mitral annulus (S(M)) (corrected CVP:CVP·S(T)/S(M)). In 16 anesthetized closed-chest dogs, S T and S M were measured by transthoracic tissue Doppler echocardiography. PCWP was varied over a wide range (1.8-40.0 mmHg) under normal condition and various types of acute and chronic HF. A significantly stronger linear correlation was observed between CVP·S(T)/S(M) and PCWP (R2 = 0.78) than between CVP and PCWP (R2 = 0.22) (P < 0.01). Receiver-operating characteristic (ROC) analysis indicated that CVP·S(T)/S(M) >10.5 mmHg predicted PCWP >18 mmHg with 85% sensitivity and 88% specificity. Area under ROC curve for CVP·S T/S M to predict PCWP >18 mmHg was 0.93, which was significantly larger than that for CVP (0.66) (P < 0.01). Peripheral venous pressure (PVP) corrected by S T/S M (PVP·S(T)/S(M) also predicted PCWP reasonably well, suggesting that PVP·S(T)/S (M) may be a minimally invasive alternative to CVP·S(T)/S(M) In conclusion, our technique is potentially useful for the reliable prediction of PCWP in HF patients.
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Affiliation(s)
- Kazunori Uemura
- Department of Cardiovascular Dynamics, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, 565-8565, Japan,
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135
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Melenovsky V, Hwang SJ, Lin G, Redfield MM, Borlaug BA. Right heart dysfunction in heart failure with preserved ejection fraction. Eur Heart J 2014; 35:3452-62. [PMID: 24875795 DOI: 10.1093/eurheartj/ehu193] [Citation(s) in RCA: 445] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
AIM Right heart function is not well characterized in patients with heart failure and preserved ejection fraction (HFpEF). The goal of this study was to examine the haemodynamic, clinical, and prognostic correlates of right ventricular dysfunction (RVD) in HFpEF. METHODS AND RESULTS Heart failure and preserved ejection fraction patients (n = 96) and controls (n = 46) underwent right heart catheterization, echocardiographic assessment, and follow-up. Right and left heart filling pressures, pulmonary artery (PA) pressures, and right-sided chamber dimensions were higher in HFpEF compared with controls, while left ventricular size and EF were similar. Right ventricular dysfunction (defined by RV fractional area change, FAC <35%) was present in 33% of HFpEF patients and was associated with more severe symptoms and greater comorbidity burden. Right ventricular function was impaired in HFpEF compared with controls using both load-dependent (FAC: 40 ± 10 vs. 53 ± 7%, P < 0.0001) and load-independent indices (FAC adjusted to PA pressure, P = 0.003), with enhanced afterload-sensitivity compared with controls (steeper FAC vs. PA pressure relationship). In addition to haemodynamic load, RVD in HFpEF was associated with male sex, atrial fibrillation, coronary disease, and greater ventricular interdependence. Over a median follow-up of 529 days (IQR: 143-1066), 31% of HFpEF patients died. In Cox analysis, RVD was the strongest predictor of death (HR: 2.4, 95% CI: 1.6-2.6; P < 0.0001). CONCLUSION Right heart dysfunction is common in HFpEF and is caused by both RV contractile impairment and afterload mismatch from pulmonary hypertension. Right ventricular dysfunction in HFpEF develops with increasing PA pressures, atrial fibrillation, male sex, and left ventricular dysfunction, and may represent a novel therapeutic target.
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Affiliation(s)
- Vojtech Melenovsky
- Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA Department of Cardiology, Institute of Clinical and Experimental Medicine - IKEM, Videnska 1958/9, Prague 4 140 28, Czech Republic
| | - Seok-Jae Hwang
- Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Grace Lin
- Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Margaret M Redfield
- Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Barry A Borlaug
- Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Moceri P, Baudouy D, Chiche O, Cerboni P, Bouvier P, Chaussade C, Ferrari E. Imaging in pulmonary hypertension: Focus on the role of echocardiography. Arch Cardiovasc Dis 2014; 107:261-71. [PMID: 24746538 DOI: 10.1016/j.acvd.2014.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Revised: 02/11/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022]
Abstract
Patients with pulmonary hypertension must be evaluated using a multimodality approach to ensure a correct diagnosis and basal evaluation as well as a prognostic assessment. Beyond the assessment of pulmonary pressures, the echocardiographical examination allows the evaluation of right ventricular adaptation to elevated afterload. Numbers of variables are commonly used in the assessment of the pulmonary hypertension patient in order to detect changes in right heart geometry, right-to-left interaction and right ventricular dysfunction. Whereas an isolated change in one echocardiographical variable is not meaningful, multiple echocardiographical variable modifications together provide accurate information. In this review, we will link pulmonary hypertension pathophysiological changes with echocardiographical indices and describe the clinical implications of echocardiographical findings.
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Affiliation(s)
- Pamela Moceri
- Service de cardiologie, hôpital Pasteur, CHU de Nice, 30, avenue de la Voie-Romaine, BP69, CS 51069, 06001 Nice cedex 1, France.
| | - Delphine Baudouy
- Service de cardiologie, hôpital Pasteur, CHU de Nice, 30, avenue de la Voie-Romaine, BP69, CS 51069, 06001 Nice cedex 1, France
| | - Olivier Chiche
- Service de cardiologie, hôpital Pasteur, CHU de Nice, 30, avenue de la Voie-Romaine, BP69, CS 51069, 06001 Nice cedex 1, France
| | - Pierre Cerboni
- Service de cardiologie, hôpital Pasteur, CHU de Nice, 30, avenue de la Voie-Romaine, BP69, CS 51069, 06001 Nice cedex 1, France
| | - Priscille Bouvier
- Service de cardiologie, hôpital Pasteur, CHU de Nice, 30, avenue de la Voie-Romaine, BP69, CS 51069, 06001 Nice cedex 1, France
| | - Claire Chaussade
- Service de cardiologie, hôpital Pasteur, CHU de Nice, 30, avenue de la Voie-Romaine, BP69, CS 51069, 06001 Nice cedex 1, France
| | - Emile Ferrari
- Service de cardiologie, hôpital Pasteur, CHU de Nice, 30, avenue de la Voie-Romaine, BP69, CS 51069, 06001 Nice cedex 1, France
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Tigen K, Pala S, Sadic BO, Karaahmet T, Dundar C, Bulut M, Izgi A, Esen AM, Kirma C. Effect of Increased Severity of Mitral Regurgitation and Preprocedural Right Ventricular Systolic Dysfunction on Biventricular and Left Atrial Mechanical Functions Following Percutaneous Mitral Balloon Valvuloplasty. Echocardiography 2014; 31:1213-20. [DOI: 10.1111/echo.12580] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Kursat Tigen
- Department of Cardiology; Marmara University Faculty of Medicine; Istanbul Turkey
| | - Selcuk Pala
- Department of Cardiology; Kartal Kosuyolu Heart Training and Research Hospital; Istanbul Turkey
| | - Beste Ozben Sadic
- Department of Cardiology; Marmara University Faculty of Medicine; Istanbul Turkey
| | - Tansu Karaahmet
- Department of Cardiology; Acibadem University School of Medicine; Istanbul Turkey
| | - Cihan Dundar
- Department of Cardiology; Kartal Kosuyolu Heart Training and Research Hospital; Istanbul Turkey
| | - Mustafa Bulut
- Department of Cardiology; Kartal Kosuyolu Heart Training and Research Hospital; Istanbul Turkey
| | - Akin Izgi
- Department of Cardiology; Kartal Kosuyolu Heart Training and Research Hospital; Istanbul Turkey
| | - Ali Metin Esen
- Department of Cardiology; Kartal Kosuyolu Heart Training and Research Hospital; Istanbul Turkey
| | - Cevat Kirma
- Department of Cardiology; Kartal Kosuyolu Heart Training and Research Hospital; Istanbul Turkey
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Koestenberger M, Ravekes W, Nagel B, Avian A, Heinzl B, Cvirn G, Fritsch P, Fandl A, Rehak T, Gamillscheg A. Reference values of the right ventricular outflow tract systolic excursion in 711 healthy children and calculation of z-score values. Eur Heart J Cardiovasc Imaging 2014; 15:980-6. [DOI: 10.1093/ehjci/jeu041] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
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Gromadziński L, Targoński R, Januszko-Giergielewicz B, Ostrowski P, Pruszczyk P. The significance of mitral and tricuspid valve systolic lateral annular velocities in the diagnosis of acute pulmonary embolism in patients with chronic heart failure. Arch Med Sci 2014; 10:39-46. [PMID: 24701212 PMCID: PMC3953976 DOI: 10.5114/aoms.2014.40732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 07/10/2012] [Accepted: 10/06/2012] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The diagnosis of acute pulmonary embolism (APE) in patients with chronic heart failure (CHF) remains a difficult task, despite the refinement of imaging techniques. The goal of this study was to assess the value of measuring tricuspid and mitral valve systolic annular velocities in CHF patients with suspected PE by tissue Doppler imaging (TDI). MATERIAL AND METHODS The study included 75 patients with previously diagnosed CHF, admitted due to resting dyspnea, with a maximum tricuspid regurgitation pressure gradient (TRPG) of ≥ 35 mm Hg and positive D-dimer assay. Spiral computed tomography (sCT) was performed on all subjects to confirm APE. Acute pulmonary embolism was diagnosed in 35 patients (PE+), and excluded in 40 others (PE-). Tissue Doppler imaging was performed to measure maximum systolic lateral annular velocities in the mitral (SmLV) and tricuspid (SmRV) valves, as well as the SmRV/SmLV ratio. RESULTS PE+ subjects were found to have higher SmLV than PE- subjects (6.0 cm/s (2.0-13.8 cm/s) vs. 4.2 cm/s (1.3-9.1 cm/s), p = 0.003). SmRV/SmLV ratios were 1.05 (0.50-2.50) and 1.56 (0.62-4.30), respectively (p < 0.0001). Areas under ROC curves for diagnosis of APE were 0.700 for SmLV and 0.789 for SmRV/SmLV. In multivariate logistic regression analysis, only SmRV/SmLV was statistically significant, with an odds ratio for APE of 6.26 (95% CI: 1.53-25.59; p = 0.009). CONCLUSIONS Tissue Doppler imaging of the lateral tricuspid and mitral annuli is a useful clinical tool that can help identify PE in CHF patients. Those patients who fulfill these criteria should be considered for further diagnostic studies to confirm PE.
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Affiliation(s)
- Leszek Gromadziński
- Department of Internal Medicine, Gastroenterology and Hepatology, University Hospital, University of Warmia and Mazury, Olsztyn, Poland
- Department of Internal Medicine, Cardiology and Nephrology, Hospital, Ostroda, Poland
| | - Ryszard Targoński
- Department of Internal Medicine and Cardiology, Municipal Hospital, Olsztyn, Poland
| | - Beata Januszko-Giergielewicz
- Department of Internal Medicine, Gastroenterology and Hepatology, University Hospital, University of Warmia and Mazury, Olsztyn, Poland
- Department of Internal Medicine, Cardiology and Nephrology, Hospital, Ostroda, Poland
| | - Philip Ostrowski
- Department of Internal Medicine and Cardiology, Warsaw Medical University, Warsaw, Poland
| | - Piotr Pruszczyk
- Department of Internal Medicine and Cardiology, Warsaw Medical University, Warsaw, Poland
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140
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Shah AM, Campbell P, Rocha GQ, Peacock A, Barst RJ, Quinn D, Solomon SD. Effect of imatinib as add-on therapy on echocardiographic measures of right ventricular function in patients with significant pulmonary arterial hypertension. Eur Heart J 2014; 36:623-32. [PMID: 24566799 DOI: 10.1093/eurheartj/ehu035] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIMS Imatinib mesylate, as add-on therapy in patients with pulmonary arterial hypertension (PAH) who remain inadequately treated despite receiving at least two PAH-specific drugs, improves exercise capacity and haemodynamics. We evaluated whether 24 weeks of add-on therapy with imatinib compared with placebo also improves right ventricular (RV) function assessed by echocardiography. METHODS AND RESULTS Echocardiograms were obtained at baseline, 12 weeks, and 24 weeks in 74 patients randomized to imatinib or placebo in the Imatinib in Pulmonary arterial hypertension, a Randomized Efficacy Study (IMPRES) trial. Right ventricular function was assessed by tissue Doppler tricuspid annular peak systolic velocity (TA S'), tricuspid annular plane systolic excursion (TAPSE), RV Tei index, and RV fractional area change. Between-treatment-group differences in the changes from baseline to week-24 were assessed using an ANCOVA with the last observation carried forward. At week-24 patients randomized to imatinib demonstrated greater improvements in TA S' (1.6 ± 2.3 imatinib vs. 0.5 ± 2.4 cm/s placebo, P = 0.007) and RV Tei index (-0.11 ± 0.18 imatinib vs. 0.05 ± 0.18 placebo, P = 0.005) compared with placebo, but not in TAPSE (0.07 ± 0.44 imatinib vs. 0.03 ± 0.32 cm placebo, P = 0.08). Imatinib therapy was also associated with significant reduction in peak tricuspid regurgitation velocity, increase in LV size, and improvement in LV early diastolic relaxation velocity. CONCLUSIONS Among patients with advanced PAH who remain symptomatic on at least two PAH-specific drugs, treatment with imatinib compared with placebo is associated with significant improvements in echocardiographic measures of RV function, in addition to LV size and LV early diastolic relaxation. CLINICAL TRIAL REGISTRATION NCT00902174 (Clinicaltrials.gov).
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Affiliation(s)
- Amil M Shah
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA
| | - Patricia Campbell
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA
| | - Gabriela Querejeta Rocha
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA
| | - Andrew Peacock
- Scottish Pulmonary Vascular Unit, Regional Heart and Lung Centre, Glasgow, UK
| | - Robyn J Barst
- Division of Pediatric Cardiology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | | | - Scott D Solomon
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, USA
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141
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Bartels K, Karhausen J, Sullivan BL, Mackensen GB. Update on Perioperative Right Heart Assessment Using Transesophageal Echocardiography. Semin Cardiothorac Vasc Anesth 2014; 18:341-51. [DOI: 10.1177/1089253214522326] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose of the review. This review aims to summarize recent findings relevant for perioperative 2- and 3-dimensional imaging of the right heart with transesophageal echocardiography. Special attention is given to developments that are likely to affect future approaches for prevention and therapy of perioperative right heart failure. Recent findings. Three-dimensional transesophageal echocardiography techniques are becoming more common for the evaluation of anatomy, volumes, and functional indices. Summary. Right heart failure continues to contribute to morbidity and mortality in the context of cardiothoracic surgery. The advent and widespread clinical use of innovative tools permitting more accurate echocardiographic assessment of the right heart will open the door to renewed interest in novel therapeutic strategies.
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Affiliation(s)
- Karsten Bartels
- Department of Anesthesiology, University of Colorado Denver, Aurora, CO, USA
- Department of Anesthesiology, Duke University, Durham, NC, USA
| | - Jörn Karhausen
- Department of Anesthesiology, Duke University, Durham, NC, USA
| | | | - G. Burkhard Mackensen
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA
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142
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Rodrigues ACT, Cordovil A, Mônaco CG, Guimarães LAB, Oliveira WAAD, Fischer CH, de Lira-Filho EB, Vieira MLC, Morhy SS. Assessing prognosis of pulmonary embolism using tissue-Doppler echocardiography and brain natriuretic peptide. EINSTEIN-SAO PAULO 2014; 11:338-44. [PMID: 24136761 PMCID: PMC4878593 DOI: 10.1590/s1679-45082013000300013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Accepted: 07/05/2013] [Indexed: 11/21/2022] Open
Abstract
Objective: To assess prognosis of pulmonary thromboembolism using tissue Doppler echocardiography and brain natriuretic peptide. Methods: Patients aged over 18 years were evaluated within 24 hours of confirmed diagnosis (chest tomography/pulmonary scintigraphy) of pulmonary embolism using two-dimensional echocardiography and tissue Doppler for right ventricular systolic (s') velocities, strain, tissue tracking and myocardial performance index. Plasma brain natriuretic peptide was also obtained within 24 hour. The influence of echocardiographic and clinical variables on mortality was examined (up to 12 months) using Cox regression analysis. Results: Out of 118 patients, 100 patients were included in the study (60 males, aged 55±17 years). Right ventricular dysfunction was observed in 28% using two-dimensional echocardiography. Tissue Doppler right ventricular variables (s' velocities, tissue tracking and strain) were decreased only for patients with right ventricular dysfunction, whereas myocardial performance index and systolic pulmonary artery pressure were increased. Mean brain natriuretic peptide value was 66±111pg/mL, also increased in patients with right ventricular dysfunction (136±146pg/mL). Mortality was 11% and related to age, malignancy and brain natriuretic peptide levels. The only echocardiographic variables capable of predicting events by univariate analysis were pulmonary pressure and right ventricular s' velocity. However, multivariate analysis showed only malignancy to predict mortality in this group. Conclusion: Lower tissue Doppler systolic velocities and elevated brain natriuretic peptide levels are associated with poorer prognosis in patients with pulmonary thromboembolism; but only malignancy emerged as an independent predictor of mortality.
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143
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Akao M, Katsube Y, Kamisago M, Watanabe M, Abe M, Fukazawa R, Ogawa S, Itoh Y. Developmental changes in left and right ventricular function evaluated with color tissue Doppler imaging and strain echocardiography. J NIPPON MED SCH 2014; 80:260-7. [PMID: 23995568 DOI: 10.1272/jnms.80.260] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIMS We evaluated the systolic and diastolic functions of both ventricles from the early neonatal period to adolescence using color tissue Doppler imaging and 2-dimensional tissue tracking echocardiography. METHODS We examined 100 healthy children (aged 1-5 days, n = 20; 1 month, n = 20; 1 year, n = 20; 6-7 years, n = 20; and 12-13 years, n = 20). Blood flow velocities in the mitral and tricuspid valves (E) were obtained with pulsed Doppler imaging, and longitudinal systolic (S') and early diastolic (E') peak velocities at the mid free wall segment of both ventricles were obtained with color tissue Doppler imaging. For longitudinal strain imaging, systolic peak values were obtained at the same position. In addition, peak systolic radial strain was obtained from a short-axis view of the left ventricle using the tissue tracking method. The E/E' ratio was calculated. RESULTS Regarding systolic indices, S' increased during development and stabilized at 6 to 7 years, and longitudinal strain reached values of the 12- to 13-year-old group at 1 year of age in both ventricles. Like longitudinal strain, radial strain in the left ventricle reached values of the 12- to 13-year-old group at the age of 1 year. Similarly, the E/E' ratio was high at 1 month or younger and decreased by 1 year. CONCLUSIONS Systolic and diastolic variables change markedly from birth to 1 year of age and show only small changes thereafter.
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Affiliation(s)
- Miharu Akao
- Department of Pediatrics, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan.
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144
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Rivera-Lebron BN, Forfia PR, Kreider M, Lee JC, Holmes JH, Kawut SM. Echocardiographic and hemodynamic predictors of mortality in idiopathic pulmonary fibrosis. Chest 2014; 144:564-570. [PMID: 23450321 DOI: 10.1378/chest.12-2298] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) can lead to the development of pulmonary hypertension, which is associated with an increased risk of death. In pulmonary arterial hypertension, survival is directly related to the capacity of the right ventricle to adapt to elevated pulmonary vascular load. The relative importance of right ventricular function in IPF is not well understood. Our objective was to evaluate right ventricular echocardiographic and hemodynamic predictors of mortality in a cohort of patients with IPF referred for lung transplant evaluation. METHODS We performed a retrospective cohort study of 135 patients who met 2011 American Thoracic Society/European Respiratory Society criteria for IPF and who were evaluated for lung transplantation at the Hospital of the University of Pennsylvania. RESULTS Right ventricle:left ventricle diameter ratio (hazard ratio [HR], 4.5; 95% CI, 1.7-11.9), moderate to severe right atrial and right ventricular dilation (HR, 2.9; 95% CI, 1.4-5.9; and HR, 2.7; 95% CI, 1.4-5.4, respectively) and right ventricular dysfunction (HR, 5.5; 95% CI, 2.6-11.5) were associated with an increased risk of death. Higher pulmonary vascular resistance was also associated with increased mortality (HR per 1 Wood unit, 1.3; 95% CI, 1.1-1.5). These risk factors were independent of age, sex, race, height, weight, FVC, and lung transplantation status. Other hemodynamic indices, such as mean pulmonary artery pressure and cardiac index, were not associated with outcome. CONCLUSIONS Right-sided heart size and right ventricular dysfunction measured by echocardiography and higher pulmonary vascular resistance by invasive hemodynamic assessment predict mortality in patients with IPF evaluated for lung transplantation.
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Affiliation(s)
- Belinda N Rivera-Lebron
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Paul R Forfia
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Penn Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Maryl Kreider
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - James C Lee
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - John H Holmes
- Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Steven M Kawut
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Penn Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
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145
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Evaluation of the right ventricle: Comparison of gated blood-pool single photon electron computed tomography and echocardiography with cardiac magnetic resonance. Int J Cardiol 2014; 171:1-8. [DOI: 10.1016/j.ijcard.2013.11.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 10/15/2013] [Accepted: 11/17/2013] [Indexed: 11/20/2022]
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146
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Role of Echocardiography in the Assessment of Right Heart Disease: Update 2013. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013. [DOI: 10.1007/s12410-013-9235-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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147
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New Aspects of Echocardiographic Assessment of Pulmonary Hypertension. CURRENT CARDIOVASCULAR IMAGING REPORTS 2013. [DOI: 10.1007/s12410-013-9226-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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148
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Cameli M, Righini FM, Lisi M, Bennati E, Navarri R, Lunghetti S, Padeletti M, Cameli P, Tsioulpas C, Bernazzali S, Maccherini M, Sani G, Henein M, Mondillo S. Comparison of right versus left ventricular strain analysis as a predictor of outcome in patients with systolic heart failure referred for heart transplantation. Am J Cardiol 2013; 112:1778-84. [PMID: 24063825 DOI: 10.1016/j.amjcard.2013.07.046] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 07/31/2013] [Accepted: 07/31/2013] [Indexed: 10/26/2022]
Abstract
The aim of the present study was to explore the relation between right ventricular (RV) and left ventricular (LV) echocardiographic parameters with clinical outcome in patients with advanced heart failure referred for cardiac transplantation. Ninety-eight consecutive patients with advanced systolic heart failure, referred for cardiac transplant evaluation, were enrolled. All patients were prospectively followed for the development of new outcome events, which included hospitalization for acute heart failure, cardiovascular death, heart transplantation, intra-aortic balloon pump implantation, and ventricular assist device implantation. Conventional transthoracic echocardiography was performed in all subjects. RV longitudinal strain (RVLS) by speckle-tracking echocardiography was assessed by averaging all segments in apical 4-chamber view (global RVLS) and by averaging RV free-wall segments (free-wall RVLS). LV global longitudinal and global circumferential strains were also calculated. Of the 98 subjects at baseline, 46 had 67 new events during a mean follow-up of 1.5 ± 0.9 years. Free-wall RVLS, global RVLS, N-terminal fragment of the prohormone brain natriuretic peptide, RV fractional area change, and LV end-diastolic volume were independently predictive of combined outcomes (all p <0.0001). The overall performance for the prediction of cardiovascular events was greatest for free-wall RVLS (area under the curve free-wall RVLS: 0.87; global RVLS: 0.67; RV fractional area change: 0.60; N-terminal fragment of the prohormone brain natriuretic peptide, 0.62; global circumferential strain: 0.55; global longitudinal strain: 0.35; and LV ejection fraction: 0.26). Free-wall RVLS showed the highest adjusted hazards ratio. A graded association between the grade of RV dysfunction and the risk of cardiovascular events was only evident for free-wall RVLS and global RVLS. In conclusion, in patients referred for heart transplantation, RVLS is a stronger predictor of outcome than LV longitudinal strain and other conventional parameters, providing a stronger prognostic stratification.
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149
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Cameli M, Righini FM, Lisi M, Mondillo S. Right ventricular strain as a novel approach to analyze right ventricular performance in patients with heart failure. Heart Fail Rev 2013; 19:603-10. [DOI: 10.1007/s10741-013-9414-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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150
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Usefulness of right atrial volume index in predicting outcome in chronic systolic heart failure. J Saudi Heart Assoc 2013; 26:73-9. [PMID: 24719536 DOI: 10.1016/j.jsha.2013.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 09/05/2013] [Accepted: 09/21/2013] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Right ventricular (RV) dysfunction is associated with poor prognosis in patients with heart failure (HF). Echocardiographic assessment of RV systolic function is challenging. The ability to visualize the right atrium (RA) allows a quantitative, highly reproducible assessment of RA volume. OBJECTIVE The aim is to study the relationship between the right atrial volume index (RAVI) and prognosis in patients with chronic systolic HF. METHODS 120 patients with chronic systolic HF and left ventricular ejection fraction (LVEF) <40% were enrolled. The RA volume was calculated by Simpson's method using single-plane RA area and indexed to body surface area (RAVI). RV systolic assessment was done using the RV fractional area change (RVFAC), and peak systolic velocity (Satri) using tissue Doppler imaging at the tricuspid annulus. The primary endpoint was death, urgent transplantation, or acute HF episode requiring hospital admission during a follow-up of 1 year. RESULTS Follow up was complete for 117 of 120 patients. Fifty-two patients reached the primary endpoint. The mean RAVI was higher in patients with adverse events (45.5 ± 15 ml/m(2) versus 25.2 ± 11 ml/m(2), p < 0.001), and increased with worsening LVEF, RVFAC, Satri (Spearman's r = -0.46, r = -0.45, r = -0.59, p < 0.001 for all). RAVI was not correlated with estimates of RV diastolic dysfunction. The cut-off threshold for RAVI to predict the primary endpoint using receiver-operating characteristic curve was 29 ml/m(2) (area under the curve was 0.89%, 95% confidence interval: 0.82-0.95) with a sensitivity of 92%, and a specificity of 75%. NYHA > 2 (OR = 2.1, p < 0.01), and RAVI (OR = 1.6, p < 0.05) were found to be independent predictors of adverse outcome. CONCLUSION In patients with chronic systolic HF, RAVI is an independent predictor of adverse outcome with a threshold value of 29 ml/m(2).
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