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Espe E, Stokke MK. Editorial for "MRI Assessment of Myocardial Deformation for Risk Stratification of Major Arrhythmic Events in Patients with Non-Ischemic Cardiomyopathy Eligible for Primary Prevention Implantable Cardioverter Defibrillators". J Magn Reson Imaging 2024. [PMID: 38358060 DOI: 10.1002/jmri.29300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/02/2024] [Indexed: 02/16/2024] Open
Affiliation(s)
- Emil Espe
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
| | - Mathis Korseberg Stokke
- Institute for Experimental Medical Research, Oslo University Hospital and University of Oslo, Oslo, Norway
- KG Jebsen Center for Cardiac Research, University of Oslo, Oslo, Norway
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Mahmod M, Raman B, Chan K, Sivalokanathan S, Smillie RW, Samat AHA, Ariga R, Dass S, Ormondroyd E, Watkins H, Neubauer S. Right ventricular function declines prior to left ventricular ejection fraction in hypertrophic cardiomyopathy. J Cardiovasc Magn Reson 2022; 24:36. [PMID: 35692049 PMCID: PMC9190122 DOI: 10.1186/s12968-022-00868-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 05/19/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The right ventricle (RV) in hypertrophic cardiomyopathy (HCM) tends to be neglected, as previous efforts have predominantly focused on examining the prognostic value of left ventricular (LV) abnormalities. The objectives of this study were to assess RV function in HCM, changes over time, and association with clinical outcomes. METHODS Two hundred and ninety HCM patients with preserved LV ejection fraction (LVEF ≥ 55%) and 30 age- and sex-matched controls underwent cardiovascular magnetic resonance (CMR). All patients were followed up for clinical events for a median duration of 4.4 years. Sixty-three patients had a follow-up CMR undertaken at a median interval of 5.4 years. Main study measures and outcomes were RV function (RV ejection fraction (RVEF) and RV strain) at baseline, temporal changes in RV function over time and prognostic value of RV dysfunction for predicting cardiovascular outcomes in HCM. RESULTS When compared to controls, HCM patients exhibited lower RV and LV peak global longitudinal systolic strains on feature-tracking analysis of cine images, while RVEF and LVEF were within the normal range. On follow-up CMR, both RV and LV strain parameters decreased over time. RVEF decreased at follow-up (65 ± 7% to 62 ± 7%, P < 0.001) but the change in LVEF was not significant (68 ± 10% to 66 ± 8%, P = 0.30). On clinical follow up, reduced RVEF was an independent predictor of non-sustained ventricular tachycardia (NSVT) [HR 1.10 (95% CI 1.06-1.15), P < 0.001] and composite cardiovascular events (NSVT, stroke, heart failure hospitalisation and cardiovascular death) [HR 1.07 (95% CI 1.03-1.10), P < 0.001]. RV longitudinal strain was an independent predictor of NSVT [HR 1.05 (95% CI 1.01-1.09), P = 0.029]. Patients with RVEF < 55% showed an increased risk of NSVT and composite cardiovascular events. In contrast, LVEF and LV global longitudinal strain were not predictive of such events on multivariable analysis. CONCLUSIONS In HCM, RV function, including RV strain, and LV strain decrease over time despite preserved LVEF. Reduction in RV but not LV function is associated with adverse cardiovascular outcomes. Assessing RV function in early HCM disease might have a role in risk stratification to prevent future cardiovascular events.
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Affiliation(s)
- Masliza Mahmod
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK.
| | - Betty Raman
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Kenneth Chan
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Sanjay Sivalokanathan
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Robert W Smillie
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Azlan H Abd Samat
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Rina Ariga
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Sairia Dass
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
| | - Elizabeth Ormondroyd
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford Centre for Clinical Magnetic Resonance Research (OCMR), University of Oxford, John Radcliffe Hospital, Headley Way, Oxford, OX3 9DU, UK
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Wen S, Pislaru C, Ommen SR, Ackerman MJ, Pislaru SV, Geske JB. Right Ventricular Enlargement and Dysfunction Are Associated With Increased All-Cause Mortality in Hypertrophic Cardiomyopathy. Mayo Clin Proc 2022; 97:1123-1133. [PMID: 35487787 DOI: 10.1016/j.mayocp.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/15/2021] [Accepted: 12/07/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess whether right ventricular enlargement (RVE) and right ventricular dysfunction (RVD) adversely affect prognosis in hypertrophic cardiomyopathy (HCM). PATIENTS AND METHODS Data were retrieved from Mayo Clinic's prospectively collected HCM registry between January 1, 2000, and September 30, 2012. Right ventricle (RV) size and function were semiquantitatively categorized via echocardiography as normal (RV-Norm) versus abnormal (RV-Abn) (RVE or RVD). All-cause mortality was the primary endpoint. RESULTS Of 1878 HCM patients studied (mean age 53±15 years; 41.6% female), only 71 (3.8%) had RV-Abn (24 RVE, 28 RVD, 19 combined RVE and RVD). Compared with HCM patients with RV-Norm, RV-Abn patients were older (57±14 vs 53±15 years, P=.02), more symptomatic (New York Heart Association functional class III-IV in 62.0% vs 48.6%, P=.03), had more atrial fibrillation (53.5% vs 17.3%, P<.001), and more prior implantable cardioverter-defibrillator implantation (23.9% vs 11.3%, P=.02). Median follow-up was 9.4 years with 311 deaths. Patients who were RV-Abn had higher all-cause mortality compared with RV-Norm (log-rank P<.001); 24.1% (95% CI, 15.5% to 35.3%) vs 6.1% (95% CI, 5.1% to 7.3%) at 5 years. In multivariable Cox modeling, RV-Abn (hazard ratio, 1.89; 95% CI, 1.18 to 3.03; P=.008) was associated independently with all-cause mortality after adjusting for age, female sex, New York Heart Association functional class, atrial fibrillation, hypertension, coronary artery disease, implantable cardioverter-defibrillator implantation, beta blocker use, prior septal reduction therapy, resting LV outflow tract gradient, maximal LV wall thickness, and moderate or greater tricuspid regurgitation. CONCLUSION Although perturbations in RV size and function were observed in fewer than 5% of patients with HCM, they were associated with nearly two-fold higher all-cause mortality at long-term follow-up.
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Affiliation(s)
- Songnan Wen
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Cristina Pislaru
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Steve R Ommen
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Michael J Ackerman
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA; Department of Pediatric and Adolescent Medicine, Division of Pediatric Cardiology, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, MN, USA; Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Labotorary, Mayo Clinic, Rochester, MN, USA
| | - Sorin V Pislaru
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jeffrey B Geske
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
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Berger SG, Sjaastad I, Stokke MK. Right ventricular involvement in hypertrophic cardiomyopathy: evidence and implications from current literature. SCAND CARDIOVASC J 2021; 55:195-204. [PMID: 33759664 DOI: 10.1080/14017431.2021.1901979] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objectives. In current guidelines, hypertrophic cardiomyopathy (HCM) is defined by hypertrophy of the left ventricle (LV). Less attention has been given to the right ventricle (RV) in patients with HCM. We wanted to provide an overview of current literature on RV involvement in HCM. Design. We performed a systematic search in PubMed and added additional articles by manual screening of references. The quality of the articles was assessed according to the GRADE system. Results. We identified 35 original articles on RV involvement in HCM. Based on these publications, RV hypertrophy occurs in 28-44% of HCM patients, depending on the cut-off value for hypertrophy and the method for assessment. Histological studies show the same structural changes in RV as are typically described in the LV cardiomyocyte hypertrophy and disarray, as well as fibrosis. These changes are similar, but less pronounced in the RV than in the LV. We discuss how HCM can impact the RV, either through a primary involvement similar to the LV or secondary to hemodynamic effects resulting from LV dysfunction. RV dysfunction in HCM is associated with higher mortality, partly due to an increased risk of ventricular tachycardia and sudden cardiac death. Conclusions. The evidence for RV involvement in HCM is limited. Multimodal imaging assessment of the RV should be included in the work-up of patients with HCM, and the added value of including RV function in the risk stratification algorithm should be further explored.
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Affiliation(s)
- Simon Girmai Berger
- Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway.,KG Jebsen Cardiac Research Centre, University of Oslo, Oslo, Norway
| | - Ivar Sjaastad
- Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway.,KG Jebsen Cardiac Research Centre, University of Oslo, Oslo, Norway
| | - Mathis Korseberg Stokke
- Institute for Experimental Medical Research, Oslo University Hospital, University of Oslo, Oslo, Norway.,KG Jebsen Cardiac Research Centre, University of Oslo, Oslo, Norway.,Department of Cardiology, Oslo University Hospital, Oslo, Norway
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Cavigli L, Focardi M, Cameli M, Mandoli GE, Mondillo S, D'Ascenzi F. The right ventricle in “Left-sided” cardiomyopathies: The dark side of the moon. Trends Cardiovasc Med 2020; 31:476-484. [DOI: 10.1016/j.tcm.2020.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/26/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023]
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Mitra A, Ghosh RK, Bandyopadhyay D, Ghosh GC, Kalra A, Lavie CJ. Significance of Pulmonary Hypertension in Hypertrophic Cardiomyopathy. Curr Probl Cardiol 2020; 45:100398. [DOI: 10.1016/j.cpcardiol.2018.10.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 10/14/2018] [Indexed: 12/20/2022]
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Yang F, Wang J, Li Y, Li W, Xu Y, Wan K, Sun J, Han Y, Chen Y. The prognostic value of biventricular long axis strain using standard cardiovascular magnetic resonance imaging in patients with hypertrophic cardiomyopathy. Int J Cardiol 2019; 294:43-49. [PMID: 31405582 DOI: 10.1016/j.ijcard.2019.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 07/26/2019] [Accepted: 08/02/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND Long axis strain (LAS) is a parameter derived from standard cardiovascular magnetic resonance imaging. However, the prognostic value of biventricular LAS in hypertrophic cardiomyopathy (HCM) is unknown. METHODS Patients with HCM (n = 384) and healthy volunteers (n = 150) were included in the study. Left ventricular (LV)-LAS was defined as the percentage change in the length measured from the epicardial border of the LV apex to the midpoint of a line connecting the mitral annulus at end-systole and end-diastole. Right ventricular (RV)-LAS represented the percentage change of length between epicardial border of the LV apex to the midpoint of a line connecting the tricuspid annulus at end-systole and end-diastole. The primary endpoint was a combination of all-cause death and sudden cardiac death aborted by appropriate implantable cardioverter-defibrillator discharge and cardiopulmonary resuscitation after syncope. The secondary endpoint was a combination of the primary endpoint and hospitalization for congestive heart failure. RESULTS Twenty-nine patients (7.6%) achieved the primary endpoint, and the secondary endpoint occurred in 66 (17.2%) patients. In multivariate Cox regression analysis, RV-LAS was an independent prognostic factor for the primary (hazard ratio (HR), 1.13) and secondary (HR, 1.11) endpoints. In the subgroup of patients with a normal RV ejection fraction (EF) (>45.0%, n = 345), impaired RV-LAS was associated with adverse outcomes and might add incremental prognostic value to RVEF and tricuspid annular plane systolic excursion (TAPSE) (p < 0.01). CONCLUSIONS RV-LAS is an independent predictor of adverse prognosis in HCM in addition to RVEF and TAPSE.
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Affiliation(s)
- Fuyao Yang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Jie Wang
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yuancheng Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Weihao Li
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yuanwei Xu
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Ke Wan
- Department of Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Jiayu Sun
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China
| | - Yuchi Han
- Department of Medicine (Cardiovascular Division), University of Pennsylvania, Philadelphia, PA, USA
| | - Yucheng Chen
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China; Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China; Center of Rare Diseases, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
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8
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Shah JP, Yang Y, Chen S, Hagar A, Pu XB, Xia T, Ou Y, Chen M, Chen Y. Prevalence and Prognostic Significance of Right Ventricular Dysfunction in Patients With Hypertrophic Cardiomyopathy. Am J Cardiol 2018; 122:1932-1938. [PMID: 30290881 DOI: 10.1016/j.amjcard.2018.08.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/15/2018] [Accepted: 08/20/2018] [Indexed: 12/01/2022]
Abstract
Few data are available regarding the prevalence and clinical significance of right ventricular systolic dysfunction (RVSD) in hypertrophic cardiomyopathy (HC) patients. This study aimed to evaluate right ventricular (RV) systolic function by cardiovascular magnetic resonance and explore the prevalence and prognostic significance of RVSD in HC patients. A total of 226 patients with HC assessed by cardiovascular magnetic resonance were included in this retrospective study. RVSD was defined by RV ejection fraction (RVEF) ≤45% and was present in 26 (11.5%) patients. Association between RVSD, clinical characteristics, and outcomes were analyzed. RVEF was significantly lower in patients with RVSD than without RVSD (36.2 ± 7.0% vs 60.5 ± 7.4%, p < 0.001). There was a positive correlation between RVEF and left ventricular ejection fraction (r = 0.45; p < 0.001). During a mean follow-up of 30.5 ± 23.9 months, there were 22 (9.7 %) all-cause mortality, including 12 (5.3%) cardiovascular death. Kaplan-Meier analysis showed a significantly higher risk for cardiovascular mortality in patients with RVSD (p = 0.026), but no significant difference in all-cause mortality (p = 0.118) and heart failure related rehospitalization (p = 0.485). On multivariate Cox regression analysis, RVSD (hazard ratio 5.36; confidence interval 1.39 to 20.77; p = 0.015) and RVEF (hazard ratio 0.94; confidence interval 0.89 to 0.98; p = 0.011) were independent predictors of cardiovascular mortality. In conclusion, RVSD is a common phenotype and a strong independent predictor of cardiovascular mortality in HC patients.
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Affiliation(s)
- Jageshwar Prasad Shah
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yong Yang
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Cardiology Department, Sichuan Provincial Fourth People's Hospital, Chengdu, Sichuan, China
| | - Shijian Chen
- Cardiology Department, Affiliated Minda Hospital of Hubei Institute for Nationalities, Enshi, Hubei, China
| | - Abdullah Hagar
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiao Bo Pu
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tianli Xia
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuanweixiang Ou
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mao Chen
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yucheng Chen
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Abstract
BACKGROUND The extent of right ventricular (RV) involvement in transthyretin amyloidosis (ATTR) is unknown. OBJECTIVES This study sought to establish the degree of RV involvement in ATTR amyloidosis, and compare findings with RV involvement in hypertrophic cardiomyopathy (HCM). METHODS Forty-two patients with ATTR amyloidosis and echocardiographic evidence of cardiac amyloidosis (cardiac ATTR), 19 ATTR patients with normal left ventricular (LV) wall thickness (non-cardiac ATTR), 25 patients with diagnosed HCM and 30 healthy controls were included in this study. Echocardiographic measurements for conventional parameters, as well as RV global and segmental strain, were recorded. RESULTS When comparing RV structure and function between cardiac ATTR amyloidosis and HCM patients, only segmental strain differed between the two groups. In cardiac ATTR amyloidosis, we found an RV apex-to-base strain gradient with highest deformation in the apex. This pattern was reversed in patients with HCM. CONCLUSIONS RV involvement is common in cardiac ATTR patients. The present study also detected an RV apical sparing pattern in patients with ATTR cardiomyopathy, similar to what has previously been described for the left ventricle in these patients. This pattern was not seen in HCM patients. Further studies are needed to assess the clinical importance of these findings.
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Affiliation(s)
- Sandra Arvidsson
- a Department of Clinical Physiology , Heart Centre, Umeå University , Umeå , Sweden
| | - Michael Y Henein
- b Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden
| | - Gerhard Wikström
- c Department of Medical Sciences , Cardiology, Uppsala University , Uppsala , Sweden
| | - Ole B Suhr
- b Department of Public Health and Clinical Medicine , Umeå University , Umeå , Sweden
| | - Per Lindqvist
- a Department of Clinical Physiology , Heart Centre, Umeå University , Umeå , Sweden.,d Department of Surgical and Perioperative Sciences , Umeå University , Umeå , Sweden
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Jumaah S, Çelekli A, Sucu M. The role of human urotensin-II in patients with hypertrophic cardiomyopathy. J Immunoassay Immunochem 2018; 39:150-162. [PMID: 28686108 DOI: 10.1080/15321819.2017.1344130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Hypertrophic cardiomyopathy (HCM) is a genetic condition with the hallmark feature of left ventricular hypertrophy. Human Urotensin-II (hUT-II) is regarded as a cardiovascular autacoid/hormone, and it has cardiac inotropic and hypertrophic properties. Aims of this study were to elucidate the clinical significance of serum hUT-II levels as a potential new biomarker in patients with HCM. METHODS This study included 40 HCM patients (60% males and 40% females) and were compared to 30 healthy control subjects (47% males and 53% females. All patients underwent extensive clinical, laboratory, and echocardiographic. Blood samples were taken to test for serum hUT-II levels by commercial ELISA Kit. RESULTS Serum hUT-II was significantly higher (p < 0.01) in patients with HCM (15.8 ± 2.1 pmol/L) compared with healthy controls (3.3 ± 1.7 pmol/L). With regard to HCM patient, Serum hUT-II levels were significantly higher in the female with 16.3 ± 1.9 pmol/L than the male with 15.4 ± 2.2 pmol/L (p < 0.05). Among echocardiographic parameters, hUT-II was negatively associated with ejection fraction (r = -0.160, p = 0.324). CONCLUSION Results of the first study indicated that serum hUT-II levels were markedly elevated in patients with HCM. Serum hUT-II is a novel biomarker parameter that has clinical use in patients with the severity of LVH.
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Affiliation(s)
- Saman Jumaah
- a Institute of Natural and Applied Sciences, Department of Biochemistry Science and Technology , Gaziantep University , Gaziantep , Turkey
| | - Abuzer Çelekli
- b Faculty of Arts and Science, Department of Biology , Gaziantep University , Gaziantep , Turkey
| | - Murat Sucu
- c Medical Faculty Cardiology , Gaziantep University , Gaziantep , Turkey
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Spalla I, Payne JR, Borgeat K, Luis Fuentes V, Connolly DJ. Prognostic value of mitral annular systolic plane excursion and tricuspid annular plane systolic excursion in cats with hypertrophic cardiomyopathy. J Vet Cardiol 2018; 20:154-164. [DOI: 10.1016/j.jvc.2018.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 03/26/2018] [Accepted: 04/03/2018] [Indexed: 12/31/2022]
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The Prognostic Implications of Two-Dimensional Speckle Tracking Echocardiography in Hypertrophic Cardiomyopathy. Cardiol Rev 2018; 26:130-136. [DOI: 10.1097/crd.0000000000000172] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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13
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Abstract
Assessment of right chamber function has become increasingly popular and important in recent decades, complementing the evaluation of left chamber functional parameters. The late adoption and integration of right ventricular (RV) function into a complete evaluation of cardiac function could be due in part to the difficulty in visualization of the whole right ventricle, inconsistency in the analysis of RV parameters, and poor understanding of the impact of RV function on prognosis. From M-mode to 2-dimensional (2D) measurements of RV size and function, there have been arrays of parameters that provide important information of the right ventricle. However, there are limitations of using 2D echocardiography to quantify RV volume and ejection fraction (EF), and currently accurate measurements of RV volumes and EF can be obtained using cardiac magnetic resonance (CMR) imaging. Using 3-dimensional echocardiography (3DE), the measurements of RV volumes and EF have become feasible and reproducible. Importantly, 3D measurements have been validated against CMR with higher correlation compared to 2D measurements. With the establishment of reference values, 3D echocardiography determined RV volumes and EF have the potential for better understanding of RV function and exploration of its significance for outcome research in various clinical scenarios.
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Affiliation(s)
- Victor Chien-Chia Wu
- Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.,Department of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan
| | - Masaaki Takeuchi
- Department of Laboratory and Transfusion Medicine, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
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Role of Two-Dimensional Speckle-Tracking Echocardiography Strain in the Assessment of Right Ventricular Systolic Function and Comparison with Conventional Parameters. J Am Soc Echocardiogr 2017; 30:937-946.e6. [PMID: 28803684 DOI: 10.1016/j.echo.2017.06.016] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Indexed: 11/24/2022]
Abstract
Despite the already well-known role the right side of the heart plays in many diseases, right ventricular (RV) function has only recently been carefully considered. Echocardiography is the first-line diagnostic technique for the assessment of the right ventricle and right atrium, whereas cardiac magnetic resonance is considered the gold standard but is limited by cost and availability. According to the current guidelines, systolic RV function should be assessed by several conventional measurements, but the efficacy of these parameters as diagnostic and prognostic tools has been questioned by many authors. The development in recent years of myocardial deformation imaging techniques and their application to the right heart chambers has allowed deeper evaluation of the importance of RV function in the pathophysiology of a large number of cardiovascular conditions, but the real value of this new tool has not been completely clarified. The aim of this review is to provide a wide and careful analysis of findings available in the literature about the assessment of RV systolic function by strain measurements, comparing them with conventional parameters and evaluating their role in several clinical settings.
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Guo X, Fan C, Tian L, Liu Y, Wang H, Zhao S, Duan F, Zhang X, Zhao X, Wang F, Zhu H, Lin A, Wu X, Li Y. The clinical features, outcomes and genetic characteristics of hypertrophic cardiomyopathy patients with severe right ventricular hypertrophy. PLoS One 2017; 12:e0174118. [PMID: 28323875 PMCID: PMC5360271 DOI: 10.1371/journal.pone.0174118] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 03/03/2017] [Indexed: 01/28/2023] Open
Abstract
Introduction Severe right ventricular hypertrophy (SRVH) is a rare phenotype in hypertrophic cardiomyopathy (HCM) for which limited information is available. This study was undertaken to investigate the clinical, prognostic and genetic characteristics of HCM patients with SRVH. Methods HCM with SRVH was defined as HCM with a maximum right ventricular wall thickness ≥10 mm. Whole-genome sequencing (WGS) was performed in HCM patients with SRVH. Multivariate Cox proportional hazards regression models were used to identify risk factors for cardiac death and events in HCM with SRVH. Patients with apical hypertrophic cardiomyopathy (ApHCM) were selected as a comparison group. The clinical features and outcomes of 34 HCM patients with SRVH and 273 ApHCM patients were compared. Results Compared with the ApHCM group, the HCM with SRVH group included younger patients and a higher proportion of female patients and also displayed higher cardiovascular morbidity and mortality. The multivariate Cox proportional hazards regression models identified 2 independent predictors of cardiovascular death in HCM patients with SRVH, a New York Heart Association class ≥III (hazard ratio [HR] = 8.7, 95% confidence interval (CI): 1.43-52.87, p = 0.019) and an age at the time of HCM diagnosis ≤18 (HR = 5.5, 95% CI: 1.24-28.36, p = 0.026). Among the 11 HCM patients with SRVH who underwent WGS, 10 (90.9%) were identified as carriers of at least one specific sarcomere gene mutation. MYH7 and TTN mutations were the most common sarcomere mutations noted in this study. Two or more HCM-related gene mutations were observed in 9 (82%) patients, and mutations in either other cardiomyopathy-related genes or ion-channel disease-related genes were found in 8 (73%) patients. Conclusions HCM patients with SRVH were characterized by poor clinical outcomes and the presentation of multiple gene mutations.
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Affiliation(s)
- Xiying Guo
- Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chaomei Fan
- Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- * E-mail: (CMF); (LT)
| | - Lei Tian
- Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- * E-mail: (CMF); (LT)
| | - Yanling Liu
- Department of Ultrasound, Fuwai Hospital, Beijing, China
| | - Hongyue Wang
- Department of Pathology, Fuwai Hospital, Beijing, China
| | - Shihua Zhao
- Department of Radiology, Fuwai Hospital, Beijing, China
| | - Fujian Duan
- Department of Ultrasound, Fuwai Hospital, Beijing, China
| | - Xiuling Zhang
- Department of Cardiology, Anqiu Chinese Medicine Hospital, Anqiu, China
| | - Xing Zhao
- Department of Cardiology, Heze Zone Central Hospital, Heze, China
| | - Fengqi Wang
- Department of Cardiology, Zhecheng People’s Hospital, Zhecheng, China
| | - Hongguang Zhu
- Department of Cardiology, The Harbor Hospital of Yantai, Yantai, China
| | - Aiqing Lin
- Department of Cardiology, Muping District Chinese Medicine Hospital of Yantai, Yantai, China
| | - Xia Wu
- Department of Cardiology, Laiwu Central Hospital, Laiwu, China
| | - Yishi Li
- Key Laboratory of Clinical Trial Research in Cardiovascular Drugs, Ministry of Health, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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D'Andrea A, Limongelli G, Baldini L, Verrengia M, Carbone A, Di Palma E, Vastarella R, Masarone D, Tagliamonte G, Riegler L, Calabrò R, Russo MG, Bossone E, Pacileo G. Exercise speckle-tracking strain imaging demonstrates impaired right ventricular contractile reserve in hypertrophic cardiomyopathy. Int J Cardiol 2017; 227:209-216. [DOI: 10.1016/j.ijcard.2016.11.150] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/06/2016] [Indexed: 11/15/2022]
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17
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Hamilton-Craig CR, Stedman K, Maxwell R, Anderson B, Stanton T, Chan J, Yamada A, Scalia GM, Burstow DJ. Accuracy of quantitative echocardiographic measures of right ventricular function as compared to cardiovascular magnetic resonance. IJC HEART & VASCULATURE 2016; 12:38-44. [PMID: 28616541 PMCID: PMC5454157 DOI: 10.1016/j.ijcha.2016.05.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/02/2016] [Indexed: 12/05/2022]
Abstract
Background Many echocardiographic parameters have been proposed to evaluate right ventricular (RV) systolic function. We comprehensively assessed a wide range of quantitative echocardiographic parameters in a single cohort compared with same-day cardiovascular magnetic resonance (CMR). Methods and results 92 subjects were examined prospectively: Group 1 consisted of 46 healthy controls (21 males, 33.4 ± 11.4 years), Group 2 consisted of 46 patients (20 males, 38.5 ± 18.9 years) undergoing RV functional assessment by CMR (1.5 T). Echocardiography was performed on the same day as CMR; fractional area change (RVFAC), myocardial performance index via spectral Doppler (RVMPI), RVMPI via Doppler tissue imaging (RVMPI-DTI), peak systolic myocardial velocity by DTI (RVSm), tricuspid annular plane systolic excursion (TAPSE), speckle tracking strain, and three dimensional right ventricular ejection fraction (3DE-RV). Linear regression, Bland–Altman and receiver-operator-characteristic (ROC) analyses were performed. At ROC analysis, the most predictive echocardiographic methods were; RVFAC (AUC = 0.892), RVMPI (AUC 0.785), TAPSE (AUC 0.849) and 3DE-RV (AUC 0.909). 3DE-RV appeared the most accurate compared to CMR, although underestimated true RV volumes. Conclusion As compared to CMR; 3DE-RV, RVFAC, TAPSE and RVMPI were the most reliable predictors of RV function. These parameters can be recommended for clinical use.
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Key Words
- 3DE, three dimensional echocardiography
- 3DE-RV, three-dimensional echo right ventricular ejection fraction
- CMR, cardiovascular magnetic resonance
- DTI, Doppler tissue imaging
- EF, ejection fraction
- Echocardiography
- IVCT, isovolumic contraction time
- IVRT, isovolumic relaxation time
- LV, left ventricle
- MPI, myocardial performance index
- Magnetic resonance imaging
- RV, right ventricular
- RVOT, right ventricular outflow tract
- RVSm, peak systolic myocardial velocity
- RVSm, s prime: right ventricular peak systolic myocardial velocity
- Right ventricle
- Right ventricular function
- SR, strain rate
- TAPSE, tricuspid annular peak systolic excursion
- TOF, tetralogy of Fallot
- TR, tricuspid regurgitation
- ε, strain
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Affiliation(s)
- Christian R Hamilton-Craig
- Department of Echocardiography, The Prince Charles Hospital, Brisbane, Australia.,University of Queensland, Brisbane, Australia.,University of Washington, Seattle, WA, USA
| | - Kathy Stedman
- Department of Echocardiography, The Prince Charles Hospital, Brisbane, Australia.,Queensland University of Technology, Brisbane, Australia
| | - Ryan Maxwell
- Department of Echocardiography, The Prince Charles Hospital, Brisbane, Australia
| | - Bonita Anderson
- Department of Echocardiography, The Prince Charles Hospital, Brisbane, Australia.,Queensland University of Technology, Brisbane, Australia
| | | | - Jonathan Chan
- Department of Echocardiography, The Prince Charles Hospital, Brisbane, Australia.,Menzies Health Institute Queensland, Griffith University, Australia
| | - Akira Yamada
- Fujita Health University School of Medicine, Japan.,Menzies Health Institute Queensland, Griffith University, Australia
| | - Gregory M Scalia
- Department of Echocardiography, The Prince Charles Hospital, Brisbane, Australia.,University of Queensland, Brisbane, Australia
| | - Darryl J Burstow
- Department of Echocardiography, The Prince Charles Hospital, Brisbane, Australia.,Queensland University of Technology, Brisbane, Australia.,University of Queensland, Brisbane, Australia
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Kırat T, Köse N, Altun İ, Akın F, Soylu MÖ. Possible causes of the gradient decrease in the right ventricular outflow tract in biventricular hypertrophic cardiomyopathy. Int J Cardiol 2016; 209:349. [DOI: 10.1016/j.ijcard.2015.10.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Accepted: 10/04/2015] [Indexed: 10/22/2022]
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19
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Arya B, Kerstein D, Leu CS, Hayes D, Zuckerman WA, Krishnan U, Lai WW. Echocardiographic Assessment of Right Atrial Pressure in a Pediatric and Young Adult Population. Pediatr Cardiol 2016; 37:558-67. [PMID: 26667961 DOI: 10.1007/s00246-015-1315-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/21/2015] [Indexed: 12/13/2022]
Abstract
Right atrial pressure (RAP) reflects right-sided cardiac hemodynamics and is useful in management of patients with cardiac and systemic disease. Studies in older adults demonstrated that inferior vena cava (IVC) diameter, IVC collapsibility index, hepatic vein systolic filling fraction (SFF), and right atrial volume (RAV) correlated with mean RAP at catheterization. This study aimed to assess the utility of echocardiographic parameters for assessment of RAP in children and young adults. Patients with pulmonary hypertension or heart transplantation undergoing right heart catheterization were recruited for this prospective observational pilot study. Transthoracic echocardiographic assessment of RAP was performed simultaneously with catheterization. For each parameter, three consecutive cardiac cycles were recorded. Long- and short-axis images of the IVC were obtained. RAV was assessed by area-length and biplane methods. IVC diameters and RAV were indexed to body surface area (BSA)(0.5) and (BSA)(1.4), respectively. Relationships between echocardiographic parameters and mean RAP were correlated using "Pearson's r." Fifty subjects aged 0.3-23 years (median 13, mean 12.3 ± 7 years) were enrolled. Mean RAP correlated modestly with RAV (r = 0.51, p < 0.001). Long-axis IVCmax (r = 0.30, p < 0.05) and tricuspid E wave velocity (r = 0.36, p < 0.01) also correlated with mean RAP. RV free wall tissue Doppler velocities, IVC collapsibility index, and hepatic vein SFF had no relation to mean RAP. In a pediatric and young adult population with pulmonary hypertension or heart transplantation, echocardiographic assessment of RAV and long-axis IVCmax provided a reasonable estimate of mean RAP. IVC collapsibility index and hepatic vein SFF demonstrated no association with mean RAP.
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Affiliation(s)
- Bhawna Arya
- Division of Pediatric Cardiology, Seattle Children's Hospital, University of Washington School of Medicine, 4800 Sand Point Way NE, M/S RC.2.820, PO Box 5371, Seattle, WA, 98105, USA.
| | - Diane Kerstein
- Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Cheng-Shiun Leu
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Denise Hayes
- Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Warren A Zuckerman
- Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Usha Krishnan
- Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Wyman W Lai
- Division of Pediatric Cardiology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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20
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Doesch C, Lossnitzer D, Rudic B, Tueluemen E, Budjan J, Haubenreisser H, Henzler T, Schoenberg SO, Borggrefe M, Papavassiliu T. Right Ventricular and Right Atrial Involvement Can Predict Atrial Fibrillation in Patients with Hypertrophic Cardiomyopathy? Int J Med Sci 2016; 13:1-7. [PMID: 26812947 PMCID: PMC4716814 DOI: 10.7150/ijms.13530] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 10/11/2015] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES AND BACKGROUND Atrial fibrillation (AF) is associated with clinical deterioration, stroke and disability in patients with hypertrophic cardiomyopathy (HCM). Therefore, the objective of this study was to evaluated cardiac magnetic resonance (CMR)-derived determinants for the occurrence of AF in patients with HCM. METHODS 98 Patients with HCM and 30 healthy controls underwent CMR and were followed-up for 6 ± 3 years. RESULTS 19 (19.4%) patients presented with AF at initial diagnosis, 19 (19.4%) developed AF during follow-up and 60 (61.2%) remained in sinus rhythm (SR). Compared to healthy controls, patients with HCM who remained in SR presented with significantly increased left ventricular mass, an elevated left ventricular remodeling index, enlarged left atrial volumes and reduced septal mitral annular plane systolic excursion (MAPSE) compared to healthy controls. Whereas HCM patients who presented with AF at initial diagnosis and those who developed AF during follow-up additionally presented with reduced tricuspid annular plane systolic excursion (TAPSE) and right atrial (RA) dilatation. Receiver-operator curve analysis indicated good predictive performance of TAPSE, RA diameter and septal MAPSE (AUC 0.73, 0.69 and 0.71, respectively) to detect patients at risk of developing AF. CONCLUSION Reduced MAPSE measurements and enlarged LA volumes seems to be a common feature in patients with HCM, whereas reduced TAPSE and RA dilatation only seem to be altered in patients with history of AF and those developing AF. Therefore, they could serve as easy determinable markers of AF in patients with HCM.
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Affiliation(s)
- Christina Doesch
- 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany
| | - Dirk Lossnitzer
- 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany
| | - Boris Rudic
- 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany
| | - Erol Tueluemen
- 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany
| | - Johannes Budjan
- 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany; 3. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Holger Haubenreisser
- 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany; 3. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Thomas Henzler
- 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany; 3. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Stefan O Schoenberg
- 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany; 3. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Martin Borggrefe
- 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany
| | - Theano Papavassiliu
- 1. 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany ; 2. DZHK (German Centre for Cardiovascular Research) partner site Mannheim, Germany
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21
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Roşca M, Călin A, Beladan CC, Enache R, Mateescu AD, Gurzun MM, Varga P, Băicuş C, Coman IM, Jurcuţ R, Ginghină C, Popescu BA. Right Ventricular Remodeling, Its Correlates, and Its Clinical Impact in Hypertrophic Cardiomyopathy. J Am Soc Echocardiogr 2015; 28:1329-38. [DOI: 10.1016/j.echo.2015.07.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Indexed: 10/23/2022]
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22
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Afonso L, Briasoulis A, Mahajan N, Kondur A, Siddiqui F, Siddiqui S, Alesh I, Cardozo S, Kottam A. Comparison of right ventricular contractile abnormalities in hypertrophic cardiomyopathy versus hypertensive heart disease using two dimensional strain imaging: a cross-sectional study. Int J Cardiovasc Imaging 2015; 31:1503-9. [DOI: 10.1007/s10554-015-0722-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 07/25/2015] [Indexed: 11/28/2022]
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23
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Park YH. Coronary sinus dilatation as a sign of right ventricular dysfunction in patients with heart failure. Anatol J Cardiol 2015; 15:548-9. [PMID: 26139168 PMCID: PMC5337033 DOI: 10.5152/akd.2015.15915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Yong Hyun Park
- Division of Cardiology, Department of Internal Medicine, Pusan National University, Yangsan Hospital; Yangsan-Korea.
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24
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Çakıcı M, Doğan A, Çetin M, Süner A, Polat M, Oylumlu M, Aktürk E, Abus S, Üçkardeş F. Coronary sinus dilatation is a sign of impaired right ventricular function in patients with heart failure. Anatol J Cardiol 2014; 15:542-7. [PMID: 25537995 PMCID: PMC5337032 DOI: 10.5152/akd.2014.5562] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The coronary sinus (CS) has been largely ignored by physicians due to a lack of adequate data about the importance of CS enlargement in patients with heart failure (HF). We aimed to assess whether CS dilatation develops in patients with HF and to demonstrate its relation with global myocardial function of the right ventricle (RV). METHODS In this cross-sectional study, 45 healthy subjects and 95 HF patients exhibiting left ventricular systolic dysfunction on echocardiographic examination (EF <45%) secondary to ischemic (n=56) or idiopathic dilated cardiomyopathy (DCM) (n=39) were enrolled. Patients with severe renal dysfunction and/or valve disease were excluded. CS was measured by echocardiography from the posterior atrioventricular groove in the apical four-chamber view. The RV myocardial performance index (MPI), which reflects both systolic and diastolic function of the ventricle, was detected using tissue Doppler imaging, and patients with an RV MPI >0.55 were defined as having impaired RV myocardial function. ANOVA, Kruskal-Wallis, Pearson's correlation, and multivariate logistic regression analyses were used for the statistical analysis. RESULTS The CS and RV MPI values were significantly greater both in patients with ischemic and idiopathic DCM than in controls (8.79±1.7 mm and 8.33±2.1 mm vs. 5.74±0.6 mm, and 0.64±0.07 and 0.62±0.08 vs. 0.43±0.02; p<0.001 for both, respectively). For the prediction of HF patients with impaired RV function, the cut-off value for the diameter of the CS was 7.35 mm, with a sensitivity of 83% and a specificity of 79%. CONCLUSION The CS diameter can be used as a novel echocardiographic marker that provides information about impaired RV function in patients with HF.
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Affiliation(s)
- Musa Çakıcı
- Department of Cardiology, Faculty of Medicine, Adıyaman University; Adıyaman-Turkey.
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25
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Doesch C, Zompolou C, Streitner F, Haghi D, Schimpf R, Rudic B, Kuschyk J, Schoenberg SO, Borggrefe M, Papavassiliu T. CMR-derived TAPSE measurement: a semi-quantitative method of right ventricular function assessment in patients with hypertrophic cardiomyopathy. Neth Heart J 2014; 22:557-64. [PMID: 25294643 PMCID: PMC4391187 DOI: 10.1007/s12471-014-0601-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Aim To compare cardiovascular magnetic resonance (CMR)-derived right ventricular fractional shortening (RVFS), tricuspid annular plane systolic excursion with a reference point within the right ventricular apex (TAPSEin) and with one outside the ventricle (TAPSEout) with the standard volumetric approach in patients with hypertrophic cardiomyopathy (HCM). Methods and results 105 patients with HCM and 20 healthy subjects underwent CMR. In patients with HCM, TAPSEin (r = 0.31, p = 0.001) and RVFS (r = 0.35, p = 0.0002) revealed a significant but weak correlation with right ventricular ejection fraction (RVEF), whereas TAPSEout (r = 0.57, p < 0.0001) showed a moderate correlation with RVEF. The ability to predict RVEF < 45 % in HCM patients was best for TAPSEout. In patients with hypertrophic obstructive cardiomyopathy (HOCM), RVEF showed a significant but weak correlation with TAPSEout (r = 0.36, p = 0.02) and no correlation with TAPSEin (r = 0.05, p = 0.07) and RVFS (r = 0.02, p = 0.2). In patients with hypertrophic non-obstructive cardiomyopathy (HNCM), there was a moderate correlation between RVEF and TAPSEout (r = 0.57, p < 0.0001) and a weak correlation with TAPSEin (r = 0.39, p = 0.001) and RVFS (r = 0.38, p = 0.002). In the 20 healthy controls, there was a strong correlation between RVEF and all semi-quantitative measurements. Conclusion CMR-derived TAPSEin is not suitable to determine right ventricular function in HCM patients. TAPSEout showed a good correlation with RVEF in HNCM patients but only a weak correlation in HOCM patients. TAPSEout might be used for screening but the detection of subtle changes in RV function requires the 3D volumetric approach.
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Affiliation(s)
- C Doesch
- 1st Department of Medicine Cardiology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany,
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D'Andrea A, La Gerche A, Golia E, Teske AJ, Bossone E, Russo MG, Calabrò R, Baggish AL. Right Heart Structural and Functional Remodeling in Athletes. Echocardiography 2014; 32 Suppl 1:S11-22. [DOI: 10.1111/echo.12226] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
| | - Andrè La Gerche
- Department of Medicine; St. Vincent's Hospital; University of Melbourne; Melbourne Australia
| | - Enrica Golia
- Chair of Cardiology; Second University of Naples; Naples Italy
| | - Arco J. Teske
- Department of Cardiology; Division of Heart and Lungs; University Medical Center Utrecht; Utrecht The Netherlands
| | - Eduardo Bossone
- Department of Cardiac Surgery; Istituto di Ricovero e Cura a Carattere Scientifico; Policlinico San Donato; San Donato Milanese Milan Italy
| | | | | | - Aaron L. Baggish
- Cardiovascular Performance Program; Massachusetts General Hospital; Boston Massachusetts USA
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Assessing right ventricular function in patients with hypertrophic cardiomyopathy with cardiac MRI: correlation with the New York Heart Function Assessment (NYHA) classification. PLoS One 2014; 9:e104312. [PMID: 25180597 PMCID: PMC4152157 DOI: 10.1371/journal.pone.0104312] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 07/07/2014] [Indexed: 02/05/2023] Open
Abstract
Purpose To determine whether 3.0-T magnetic resonance imaging (MRI) could assess right ventricular (RV) function in patients with hypertrophic cardiomyopathy (HCM), and if this assessment is correlated with the New York Heart Function Assessment (NYHA) classification. Materials and Methods Forty-six patients with HCM and 23 normal individuals were recruited. Left and right ventricular function parameters including end-diastolic and end-systolic volumes (EDV, ESV), stroke volume (SV) and ejection fraction (EF) and dimensions were measured and compared using 3.0-T MRI. RV function parameters between HCM patients and controls were compared using independent sample t tests. A one way ANOVA test with Bonferroni correction was used to determine significant differences among different NYHA groups. Receiver operating characteristic analyses calculated the sensitivity and specificity of RV dysfunction on MRI for the prediction of HCM severity. Results Statistical analysis revealed significant differences of left ventricular (LV) and RV volumetric values and masses between the HCM patients and controls (all p<0.05). Within the HCM group, the simultaneously decreased maximum RVEDD correlated well with the LVEDD (r = 0.53; p<0.001). The function and dimension parameters among Class I to III were not determined to be significantly different (all p>0.05). However, significant differences between the Class IV and I-III groups (all P<0.0167) indicated that the diastolic and systolic function in both the RV and LV were impaired in Class IV patients. ROC analyses identified the EDV, ESV and EDD of both the LV and RV with a high sensitivity cutoff value to predict the HCM patients with severe heart failure (Class IV) with high sensitivity and specificity. Conclusions RV involvements were comparable to those of LV global function impairments in patients with HCM. The presence of RV dysfunction and decreased dimension on the MRI helped to predict the severe symptomatic HCM with high sensitivity and specificity.
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Finocchiaro G, Knowles JW, Pavlovic A, Perez M, Magavern E, Sinagra G, Haddad F, Ashley EA. Prevalence and clinical correlates of right ventricular dysfunction in patients with hypertrophic cardiomyopathy. Am J Cardiol 2014; 113:361-7. [PMID: 24230980 DOI: 10.1016/j.amjcard.2013.09.045] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 09/27/2013] [Accepted: 09/27/2013] [Indexed: 10/26/2022]
Abstract
Hypertrophic cardiomyopathy (HC) is a disease that mainly affects the left ventricle (LV), however recent studies have suggested that it can also be associated with right ventricular (RV) dysfunction. The objective of this study was to determine the prevalence of RV dysfunction in patients with HC and its relation with LV function and outcome. A total of 324 consecutive patients with HC who received care at Stanford Hospital from 1999 to 2012 were included in the study. A group of 99 prospectively recruited age- and gender-matched healthy volunteers were used as controls. RV function was quantified using the RV fractional area change, tricuspid annular plane systolic excursion (TAPSE), and RV myocardial performance index (RVMPI). Compared with the controls, the patients with HC had a higher RVMPI (0.51 ± 0.18 vs 0.25 ± 0.06, p <0.001) and lower TAPSE (20 ± 3 vs 24 ± 4, p <0.001). RV dysfunction based on an RVMPI >0.4 and TAPSE <16 mm was found in 71% and 11% of the HC and control groups, respectively. Worst LV function and greater pulmonary pressures were independent correlates of RV dysfunction. At an average follow-up of 3.7 ± 2.3 years, 17 patients had died and 4 had undergone heart transplantation. LV ejection fraction <50% and TAPSE <16 mm were independent correlates of outcome (hazard ratio 3.98, 95% confidence interval 1.22 to 13.04, p = 0.02; and hazard ratio 3.66, 95% confidence interval 1.38 to 9.69, p = 0.009, respectively). In conclusion, RV dysfunction based on the RVMPI is common in patients with HC and more frequently observed in patients with LV dysfunction and pulmonary hypertension. RV dysfunction based on the TAPSE was independently associated with an increased likelihood of death or transplantation.
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Badran HM, Soliman M, Hassan H, Abdelfatah R, Saadan H, Yacoub M. Right ventricular mechanics in hypertrophic cardiomyopathy using feature tracking. Glob Cardiol Sci Pract 2013; 2013:185-97. [PMID: 24689019 PMCID: PMC3963737 DOI: 10.5339/gcsp.2013.25] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 06/04/2013] [Indexed: 11/26/2022] Open
Abstract
Objectives: Right ventricular (RV) mechanics in hypertrophic cardiomyopathy (HCM) are poorly understood. We investigate global and regional deformation of the RV in HCM and its relationship to LV phenotype, using 2D strain vector velocity imaging (VVI). Methods: 100 HCM patients (42% females, 41 ± 19 years) and 30 control patients were studied using VVI. Longitudinal peak systolic strain (ϵsys), strain rate (SR), time to peak (ϵ) (TTP), displacement of RV free wall (RVFW) and septal wall were analyzed. Similar parameters were quantified in LV septal, lateral, anterior and inferior segments. Intra-V-delay was defined as SD of TTP. Inter-V-delay was estimated from TTP difference between the most delayed LV segment & RVFW. Results: ϵsys and SR of both RV & LV, showed loss of base to apex gradient and significant decline in HCM (p < 0.001). Deformation variables estimated from RVFW were strongly correlated with each other (r = 0.93, p < 0.0001). Both were directly related to LV ϵsys, SRsys, SRe, ejection fraction (EF)%, RVFW displacement (P < 0.001) and inversely related to age, positive family history (p < 0.004, 0.005), RV wall thickness, maximum wall thickness (MWT), intra-V-delay, LA volume (P < 0.0001), LVOT gradient (p < 0.02, 0.005) respectively. ROC curves were constructed to explore the cut-off point that discriminates RV dysfunction. Global and RVFW ϵsys: − 19.5% shows 77, 70% sensitivity & 97% specificity, SRsys: − 1.3s− 1 shows 82, 70% sensitivity & 30% specificity. Multivariate analyses revealed that RVFW displacement (β = − 0.9, p < 0.0001) and global LV SRsys (β = 5.9, p < 0.0001) are independent predictors of global RV deformation. Conclusions: Impairment of RV deformation is evident in HCM using feature tracking. It is independently influenced by LV mechanics and correlated to the severity of LV phenotype. RVFW deformation analysis and global RV assessment are comparable.
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Henein M, Mörner S, Lindmark K, Lindqvist P. Impaired left ventricular systolic function reserve limits cardiac output and exercise capacity in HFpEF patients due to systemic hypertension. Int J Cardiol 2012. [PMID: 23176776 DOI: 10.1016/j.ijcard.2012.11.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Heart failure (HF) patients with preserved left ventricular (LV) ejection fraction (EF) (HFpEF) due to systemic hypertension (SHT) are known to have limited exercise tolerance. Despite having normal EF at rest, we hypothesize that these patients have abnormal systolic function reserve limiting their exercise capacity. METHODS Seventeen patients with SHT (mean age 68 ± 9 years) but no valve disease and 14 healthy individuals (mean age of 65 ± 10 years) underwent resting and peak exercise echocardiography using conventional, tissue Doppler and speckle tracking techniques. The differences between resting and peak exercise values were also analyzed (Δ). Exercise capacity was determined as the workload divided by body surface area. RESULTS Resting values for left atrial (LA) volume/BSA (r=-0.66, p<0.001) and global longitudinal strain rate (GLSR) in early (e) and late (a) diastole (r=0.47 and 0.46, p<0.05 for both) correlated with exercise capacity. LVEF increased during exercise in normals (mean Δ EF=10 ± 8%) but failed to do so in patients (mean Δ EF=0.6 ± 9%, p<0.001 between groups). LV GLSR during systole (s) also failed to increase with exercise in patients, to the same extent as it did in normals (0.2 ± 0.2 vs. 0.6 ± 0.3 1/s, p<0.001). The difference between rest and exercise (Δ) in LV lateral wall systolic velocity from tissue Doppler (s') (0.71, p<0.001), Δ in cardiac output (r=0.60, p<0.001) and Δ GLSRs (r=0.48, p<0.05) all correlated with exercise capacity independent of changes in heart rate. CONCLUSION HFpEF patients with hypertensive LV disease have significantly limited exercise capacity which is related to left atrial enlargement as well as compromised LV systolic function at the time of the symptoms. The limited myocardial systolic function reserve seems to be underlying important explanation for their limited exercise capacity.
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Affiliation(s)
- Michael Henein
- Department of Cardiology, Umeå University, Umeå, Sweden; Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Goldberg DJ, French B, Szwast AL, McBride MG, Marino BS, Mirarchi N, Hanna BD, Wernovsky G, Paridon SM, Rychik J. Impact of sildenafil on echocardiographic indices of myocardial performance after the Fontan operation. Pediatr Cardiol 2012; 33:689-96. [PMID: 22331056 PMCID: PMC4379708 DOI: 10.1007/s00246-012-0196-9] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 11/23/2011] [Indexed: 11/30/2022]
Abstract
The objective of this study was describe the impact of sildenafil on echocardiographic measures of myocardial performance in children and young adults with a functional single-ventricle physiology late after Fontan surgery. A double-blind, placebo-controlled, crossover trial was conducted in children and young adults after the Fontan operation at a single pediatric center. Subjects were randomized to receive placebo or sildenafil (20 mg tid) for 6 weeks. After a 6-week washout period, subjects were crossed for an additional 6 weeks. Each subject underwent an echocardiogram at the start and finish of each phase. A total of 27 subjects completed study testing at a mean age of 14.9 years and a mean time from Fontan surgery of 11.3 years. After sildenafil, subjects demonstrated improvement in their myocardial performance index (MPI; -0.051; 95% CI -0.095, -0.0077; p 0.02) and in the product of the velocity time integral (VTI) of the dominant outflow tract and the heart rate (HR; 110 cm × bpm; 95% CI 7.5, 220; p = 0.04). Measures of diastolic performance, including inflow velocities, myocardial velocities, and the ratio of blood pool velocity to myocardial velocity during passive inflow, did not change. In this cohort, there were significant improvements in both the MPI and the product of the VTI × HR after 6 weeks of treatment with sildenafil. These findings suggest that sildenafil may be a useful therapy to improve or maintain ventricular performance in select patients after the Fontan operation.
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Affiliation(s)
- David J. Goldberg
- Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Department of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Benjamin French
- Department of Biostatistics and Epidemiology, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Anita L. Szwast
- Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Department of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Michael G. McBride
- Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Bradley S. Marino
- Divisions of Cardiology and Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Nicole Mirarchi
- Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Brian D. Hanna
- Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Department of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Gil Wernovsky
- Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Department of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Stephen M. Paridon
- Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Department of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Jack Rychik
- Division of Cardiology, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA,Department of Pediatrics, The Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
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Vizzardi E, D’Aloia A, Bordonali T, Bugatti S, Piovanelli B, Bonadei I, Quinzani F, Rovetta R, Vaccari A, Curnis A, Dei Cas L. Long-Term Prognostic Value of the Right Ventricular Myocardial Performance Index Compared to Other Indexes of Right Ventricular Function in Patients with Moderate Chronic Heart Failure. Echocardiography 2012; 29:773-8. [DOI: 10.1111/j.1540-8175.2012.01703.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Pagourelias ED, Efthimiadis GK, Parcharidou DG, Gossios TD, Kamperidis V, Karoulas T, Karvounis H, Styliadis IH. Prognostic value of right ventricular diastolic function indices in hypertrophic cardiomyopathy. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2011; 12:809-17. [DOI: 10.1093/ejechocard/jer126] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Darsaklis K, Afilalo J, Rudski LG. Assessment of the Right Ventricle in Adults: What Have the Guidelines Taught Us? CURRENT CARDIOVASCULAR IMAGING REPORTS 2011. [DOI: 10.1007/s12410-011-9100-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 2010; 23:685-713; quiz 786-8. [PMID: 20620859 DOI: 10.1016/j.echo.2010.05.010] [Citation(s) in RCA: 5007] [Impact Index Per Article: 357.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Lawrence G Rudski
- Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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D'Andrea A, Caso P, Bossone E, Scarafile R, Riegler L, Di Salvo G, Gravino R, Cocchia R, Castaldo F, Salerno G, Golia E, Limongelli G, De Corato G, Cuomo S, Pacileo G, Russo MG, Calabro R. Right ventricular myocardial involvement in either physiological or pathological left ventricular hypertrophy: an ultrasound speckle-tracking two-dimensional strain analysis. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2010; 11:492-500. [DOI: 10.1093/ejechocard/jeq007] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Zimbarra Cabrita I, Ruisanchez C, Dawson D, Grapsa J, North B, Howard LS, Pinto FJ, Nihoyannopoulos P, Gibbs JSR. Right ventricular function in patients with pulmonary hypertension; the value of myocardial performance index measured by tissue Doppler imaging. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2010; 11:719-24. [PMID: 20410189 DOI: 10.1093/ejechocard/jeq051] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
AIMS Myocardial performance index (MPI) measured by conventional Doppler is routinely used to assess right ventricular (RV) systolic function in patients with pulmonary hypertension (PH). Our aim was to determine whether MPI measured by Doppler tissue imaging (tMPI) is effective in assessing RV function in these patients. METHODS AND RESULTS Retrospectively, we have studied 196 patients with chronic PH [pulmonary arterial systolic pressure (PASP) 81 +/- 40 mmHg] and 37 healthy volunteers (PASP of 27 +/- 7 mmHg). According to the exclusion criteria, 172 patients were included in the final study cohort. All patients were evaluated for RV systolic function by different parameters. MPI was measured by both conventional and tissue Doppler imaging. Bland-Altman analysis showed moderate agreement between MPI and tMPI (the mean difference was -0.02, absolute difference = -0.32 to 0.29; 95% intervals of agreement, percentage of average = -46.6 to 40.8%). In 50 consecutive PH patients where additional parameters were calculated, we found a significant correlation between tMPI and RV ejection fraction (r = -0.73, P< 0.0001) and RV fractional area change (r = -0.58, P< 0.0001). No significant inter- and intra-observer variability was identified. CONCLUSION This study demonstrated a moderate agreement between two methods of measuring MPI. A good correlation of tMPI with RV ejection fraction and RV fractional area change was found indicating that tMPI might be superior to MPI Doppler. tMPI is a parameter unaffected by RV geometry and importantly has the advantage of simultaneously recording the time intervals from the same cardiac cycle.
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Affiliation(s)
- Inês Zimbarra Cabrita
- Department of Cardiovascular Sciences, Hammersmith Hospital, Imperial College London, NHLI, Du Cane Road, W12 0HS London, UK.
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Sade LE, Gülmez Ö, Özyer U, Özgül E, Ağıldere M, Müderrisoğlu H. Tissue Doppler Study of the Right Ventricle with a Multisegmental Approach: Comparison with Cardiac Magnetic Resonance Imaging. J Am Soc Echocardiogr 2009; 22:361-8. [DOI: 10.1016/j.echo.2009.01.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Indexed: 11/16/2022]
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Cheng TO. Hypertrophic cardiomyopathy is a biventricular disease. Int J Cardiol 2008; 129:3-4. [DOI: 10.1016/j.ijcard.2008.02.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Accepted: 02/13/2008] [Indexed: 11/16/2022]
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