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Lakatos BK, Rako Z, Szijártó Á, da Rocha BRB, Richter MJ, Fábián A, Gall H, Ghofrani HA, Kremer N, Seeger W, Zedler D, Yildiz S, Yogeswaran A, Merkely B, Tello K, Kovács A. Right ventricular pressure-strain relationship-derived myocardial work reflects contractility: Validation with invasive pressure-volume analysis. J Heart Lung Transplant 2024; 43:1183-1187. [PMID: 38508504 DOI: 10.1016/j.healun.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 03/22/2024] Open
Abstract
Three-dimensional (3D) echocardiography-derived right ventricular (RV) ejection fraction (EF) and global longitudinal strain (GLS) are valuable RV functional markers; nevertheless, they are substantially load-dependent. Global myocardial work index (GMWI) is a novel parameter calculated by the area of the RV pressure-strain loop. By adjusting myocardial deformation to instantaneous pressure, it may reflect contractility. To test this hypothesis, we enrolled 60 patients who underwent RV pressure-conductance catheterization to determine load-independent markers of RV contractility and ventriculo-arterial coupling. Detailed 3D echocardiography was also performed, and we calculated RV EF, RV GLS, and using the RV pressure trace curve, RV GWMI. While neither RV EF nor GLS correlated with Ees, GMWI strongly correlated with Ees. In contrast, RV EF and GLS showed a relationship with Ees/Ea. By dividing the population based on their Reveal Lite 2 risk classification, different characteristics were seen among the subgroups. RV GMWI may emerge as a useful clinical tool for risk stratification and follow-up in patients with RV dysfunction.
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Affiliation(s)
- Bálint K Lakatos
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
| | - Zvonimir Rako
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Ádám Szijártó
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Bruno R Brito da Rocha
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Manuel J Richter
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Alexandra Fábián
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Henning Gall
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Hossein A Ghofrani
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany; Division of Pulmonology, Department of Internal Medicine, Universities of Giessen, Giessen, Germany; Department of Pneumology, Kerckhoff Heart, Rheuma and Thoracic Centre, Bad Nauheim, Germany
| | - Nils Kremer
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Werner Seeger
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Daniel Zedler
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Selin Yildiz
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Athiththan Yogeswaran
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Béla Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Khodr Tello
- Department of Internal Medicine, Justus-Liebig-University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Member of the German Centre for Lung Research, Giessen, Germany
| | - Attila Kovács
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary; Department of Surgical Research and Techniques, Semmelweis University, Budapest, Hungary
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Randazzo M, Maffessanti F, Kotta A, Grapsa J, Lang RM, Addetia K. Added value of 3D echocardiography in the diagnosis and prognostication of patients with right ventricular dysfunction. Front Cardiovasc Med 2023; 10:1263864. [PMID: 38179507 PMCID: PMC10764503 DOI: 10.3389/fcvm.2023.1263864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/22/2023] [Indexed: 01/06/2024] Open
Abstract
Recent inroads into percutaneous-based options for the treatment of tricuspid valve disease has brought to light how little we know about the behavior of the right ventricle in both health and disease and how incomplete our assessment of right ventricular (RV) physiology and function is using current non-invasive technology, in particular echocardiography. The purpose of this review is to provide an overview of what three-dimensional echocardiography (3DE) can offer currently to enhance RV evaluation and what the future may hold if we continue to improve the 3D evaluation of the right heart.
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Affiliation(s)
- Michael Randazzo
- Department of Medicine, Section of Cardiology, University of Chicago Heart and Vascular Center, Chicago, IL, United States
| | | | - Alekhya Kotta
- Department of Internal Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Julia Grapsa
- Department of Cardiology, Guys and St Thomas NHS Trust, London, United Kingdom
| | - Roberto M. Lang
- Department of Medicine, Section of Cardiology, University of Chicago Heart and Vascular Center, Chicago, IL, United States
| | - Karima Addetia
- Department of Medicine, Section of Cardiology, University of Chicago Heart and Vascular Center, Chicago, IL, United States
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