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Matos JI, García-Rodríguez SN, Costa-Rodríguez N, Caro-Vadillo A, Carretón E, Montoya-Alonso JA. Right Ventricle Strain Assessed by 2-Dimensional Speckle Tracking Echocardiography (2D-STE) to Evaluate Pulmonary Hypertension in Dogs with Dirofilaria immitis. Animals (Basel) 2023; 14:26. [PMID: 38200757 PMCID: PMC10778325 DOI: 10.3390/ani14010026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/07/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Echocardiographic assessment of the right ventricle is helpful for analysing the pathophysiology of heartworm disease and detecting pulmonary hypertension (PH) in dogs. In veterinary cardiology, the study of myocardial deformation using two-dimensional speckle tracking (2D-STE) echocardiography has become increasingly acknowledged as useful for quantifying right ventricular function. The aim of this study was to evaluate the usefulness of myocardial deformation strain of the right ventricular free wall (FWS), global deformation strain of the right ventricle, including the interventricular septum (GS), and tissue motion annular displacement of the tricuspid valve (TMAD) in a cohort of dogs with heartworm (Dirofilaria immitis) disease and to determine cut-off values for detecting the presence of PH. Out of the 93 dogs tested, 71% were diagnosed with heartworm infection. PH was identified in 41% of the infected dogs following the American College of Veterinary Internal Medicine (ACVIM) guidelines, based on the peak tricuspid regurgitation velocity to calculate the tricuspid regurgitation pressure gradient (TRPG), while other routine measurements were used, including the right pulmonary artery distensibility index (RPADi). The 2D-STE mode measurements were determined using Right Ventricular Automated Function Imaging (RV AFI®) software. The statistical analysis showed significant differences in the studied parameters among dogs with and without PH. Additionally, sensitivity (sen) and specificity (sp) cut-off values were obtained (GS ≥ -21.25%, sen 96%, sp 86.4%; FWS ≥ -21.95%, sen 92.56%, sp 95.5%; TMAD ≤ 0.85 cm, sen 70.4%, sp 83.3%). These results demonstrated that GS, FWS, and TMAD could be used as supplementary and alternative variables to conventional echocardiographic measurements when detecting PH in dogs with heartworm disease.
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Affiliation(s)
- Jorge Isidoro Matos
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
| | - Sara Nieves García-Rodríguez
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
| | - Noelia Costa-Rodríguez
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
| | - Alicia Caro-Vadillo
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
- Hospital Clínico Veterinario, Faculty of Veterinary Medicine, Universidad Complutense de Madrid (UCM), 28040 Madrid, Spain
| | - Elena Carretón
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
| | - José Alberto Montoya-Alonso
- Internal Medicine, Faculty of Veterinary Medicine, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, 35001 Las Palmas de Gran Canaria, Spain; (J.I.M.); (S.N.G.-R.); (J.A.M.-A.)
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Liu Q, Hu Y, Chen W, Yao T, Li W, Xiao Z, Liu J, Xiao Y. Evaluation of right ventricular longitudinal strain in pediatric patients with pulmonary hypertension by two-dimensional speckle-tracking echocardiography. Front Pediatr 2023; 11:1189373. [PMID: 37780047 PMCID: PMC10540637 DOI: 10.3389/fped.2023.1189373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/30/2023] [Indexed: 10/03/2023] Open
Abstract
Objectives We aimed to investigate the association between right ventricular longitudinal strain measured by two-dimensional speckle-tracking echocardiography (2D-STE) and right heart catheterization data in pediatric patients with pulmonary hypertension (PH). Methods Two groups were evaluated, each consisting of 58 patients. Group 1, patients with PH; Group 2, normal matched controls. Data were collected from 58 patients with PH who underwent invasive hemodynamic evaluation. Standard transthoracic echocardiographic assessment was performed in all patients under the same circumstances. All patients underwent 2D-STE, and off-line analysis generated right ventricle longitudinal strain (RVLS) and right ventricular free wall strain (RVFW) and collected echocardiographic conventional parameters of right ventricular function, including the control group. The relationship between invasive characteristics and right ventricular function parameters was analyzed. Results In all, 58 PH patients were included in our study. The mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) were strongly correlated with right ventricular free wall strain (RVFW) and right ventricular longitudinal strain (RVLS), moderately correlated with the right ventricle myocardial performance index (Tei index), weakly correlated with the transverse diameter of the right ventricle (RV) and the transverse diameter of the right atrium (RA), and moderately negatively correlated with right ventricular fractional area change (RVFAC). In terms of segments of the right ventricular free wall, the basal segment had the highest correlation coefficient with mPAP and PVR (r = 0.413, 0.523, 0.578, r = 0.421, 0.533, 0.575, p < 0.05, respectively). Tricuspid annular plane systolic excursion (TAPSE), main pulmonary artery diameter (MPA), peak systolic velocity of the right ventricle (RV-S'), and RA area parameters were not associated with mPAP and PVR (p > 0.05). Conclusions Right ventricular longitudinal strain is a reliable indicator to evaluate right ventricular function in pediatric patients with PH. It can provide valuable reference information for the clinical judgment of the status and severity of the disease in children.
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Affiliation(s)
- Qianjun Liu
- Department of Ultrasound, Hunan Children’s Hospital, Changsha, China
| | - Yuan Hu
- Department of Ultrasound, Hunan Children’s Hospital, Changsha, China
| | - Wenjuan Chen
- Department of Ultrasound, Hunan Children’s Hospital, Changsha, China
| | - Taoyue Yao
- Department of Ultrasound, Hunan Children’s Hospital, Changsha, China
| | - Wenfeng Li
- Department of Ultrasound, Hunan Children’s Hospital, Changsha, China
| | - Zhenghui Xiao
- Intensive Care Unit, Hunan Children’s Hospital, Changsha, China
| | - Jinqiao Liu
- Department of Ultrasound, Hunan Children’s Hospital, Changsha, China
| | - Yunbin Xiao
- Department of Cardiology, Hunan Children’s Hospital, Changsha, China
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Charles Jain C, Egbe AC, Oh JK, Connolly HM, Miranda WR. Echo-Doppler and strain assessment of filling pressures in adults with congenitally corrected transposition and systemic right ventricles. Eur Heart J Cardiovasc Imaging 2023; 24:454-462. [PMID: 35866302 DOI: 10.1093/ehjci/jeac115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
AIMS Systolic dysfunction of the systemic right ventricle (sRV) is common in adults with transposition of the great arteries and sRV. In acquired disease, diastology analysis for assessment of filling pressures (FP) is paramount in patient care. METHODS AND RESULTS Retrospective analysis of 47 adults with sRV without prior systemic tricuspid valve surgery undergoing catheterization and echocardiography within 7 days (median -2 [-1, -3]) from January 2000 to February 2021 at our institution. Median age was 48 (31, 55) years, and 16 (34.0%) patients were female. FPs were normal in 21 patients (44.7%). Left atrial size was enlarged in most patients (83.0%) with mean indexed value 58.3 ± 23.4 mL/m2. Tissue Doppler e' was not significantly different between those with high FPs vs. normal (medial 0.07 ± 0.03 vs. 0.08 ± 0.03 m/s, P = 0.63; lateral 0.08 ± 0.04 vs. 0.08 ± 0.04 m/s, P = 0.88). E velocity and subpulmonic mitral regurgitant velocity were higher in those with high FPs (0.9 ± 0.3 vs. 0.6 ± 0.2 m/s, P = 0.005; 3.8 ± 1.1 vs. 2.8 ± 0.9 m/s, P = 0.004). Left atrial reservoir strain, sRV global longitudinal strain, and subpulmonic left ventricular strain were worse in those with high FP (18.0 ± 7.6 vs. 27.9 ± 10.2%, P = 0.0009; -13.0 ± 4.4 vs. -17.9 ± 5.0%, P = 0.002; -16.8 ± 5.7 vs. -23.0 ± 3.8%, P = 0.001). CONCLUSION Despite the complex anatomy, FPs can be assessed non-invasively in adults with sRV without prior systemic tricuspid valve surgery. The current guideline algorithm for diastolic dysfunction in acquired heart disease has limited applicability in this population. Given the limitations of Doppler in this heterogeneous population, strain analysis can be a helpful adjunct for estimation of FPs.
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Affiliation(s)
- C Charles Jain
- Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Alexander C Egbe
- Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Jae K Oh
- Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - Heidi M Connolly
- Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
| | - William R Miranda
- Department of Cardiovascular Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA
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Espinola-Zavaleta N, Antonio-Villa NE, Guerra EC, Nanda NC, Rudski L, Alvarez-Santana R, Camacho-Camacho G, Aranda-Fraustro A, Cossio-Aranda J, Zamora K, Oregel-Camacho D, Armenta-Moreno JI, Berarducci J, Alexanderson-Rosas E. Right Heart Chambers Longitudinal Strain Provides Enhanced Diagnosis and Categorization in Patients With Pulmonary Hypertension. Front Cardiovasc Med 2022; 9:841776. [PMID: 35433867 PMCID: PMC9008240 DOI: 10.3389/fcvm.2022.841776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Background Increased systolic pulmonary arterial pressure (sPAP) could lead to the mechanical dysfunction and myocardial fibrosis of the right heart chambers. Echocardiographic strain analysis has not been adequately studied in patients with pulmonary hypertension (PH). Study design and methods A cross-sectional cohort of patients with suspected PH and echocardiographic strain evaluation was recruited. The cut-off values of peak tricuspid regurgitation velocity (TRV) with the low probability of PH (≤2.8 m/s), intermediate probability (2.9-3.4 m/s, without other echo PH signs), and high probability of PH (2.9-3.4 m/s with other echo PH signs and >3.4 m/s) categories were studied by right ventricular and right atrial (RA) strain analysis in a sample of 236 patients. Results The results showed that 58 (56.9%) patients had low, 15 (14.7%) had intermediate, and 29 (28.4%) had a high probability of PH. We observed a negative association between right ventricular free wall strain (RV-FWS) and atrial global strain with sPAP. With the increase in PH severity, RA reservoir, conduit, and contraction (booster) strain values decreased. The identified cut-off values of strain parameters had an adequate ability to detect PH severity categories. In addition, the post-mortem biopsies of right heart chambers from subjects with known severe PH were analyzed to quantify myocardial fibrosis. Our sample of right heart biopsies (n = 12) demonstrated an association between increased sPAP before death and right ventricular and RA fibrosis. Conclusion Mechanical dysfunction and fibrosis in the right chambers are associated with increased sPAP. Right ventricular and atrial strain could provide enhancement in the diagnosis and categorization of subjects with suspected PH.
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Affiliation(s)
- Nilda Espinola-Zavaleta
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
- Department of Echocardiography, The American British Cowdray Medical Center, Private Assistance Institution, Mexico City, Mexico
| | | | - Enrique C. Guerra
- MD/Ph.D. (PECEM) Program, Facultad de Medicina, Universidad Nacional Autonoma de Mexico, Mexico City, Mexico
| | - Navin C. Nanda
- Division of Cardiology, Department of Medicine, University of Alabama, Birmingham, AL, United States
| | - Lawrence Rudski
- Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Ricardo Alvarez-Santana
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Gyssele Camacho-Camacho
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
- Inter-Institutional Program for Strengthening Research and Postgraduate Studies in the Pacific (Dolphin), Mexico City, Mexico
| | - Alberto Aranda-Fraustro
- Department of Pathology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Jorge Cossio-Aranda
- Out-Patient Clinic, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Karina Zamora
- Out-Patient Clinic, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Diego Oregel-Camacho
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
- Inter-Institutional Program for Strengthening Research and Postgraduate Studies in the Pacific (Dolphin), Mexico City, Mexico
| | | | - Joaquin Berarducci
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - Erick Alexanderson-Rosas
- Department of Nuclear Cardiology, National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
- Department of Physiology, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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Shang X, Zhang C, Liu M, Lu R, Wang Y. Right ventricular contractility as a potential independent evaluation parameter in pulmonary hypertension. Int J Clin Pract 2021; 75:e14183. [PMID: 33768650 DOI: 10.1111/ijcp.14183] [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: 12/14/2020] [Accepted: 03/14/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Pulmonary artery hypertension (PAH) is a common disease with high disability and mortality rates, and can lead to right heart failure. We aimed to evaluate the capability of right ventricular pressure-volume coupling parameters, end-systolic elastance (Ees), right ventricular afterload (Ea), and arterial elastance (Ees/Ea) for assessing right ventricular performance during the chronic development of PAH. METHODS Thirty-six PAH patients were enrolled in this study. We reported the cutoff values of the right ventricular pressure-volume coupling parameters in the progression of PAH and their relations with other pressure-volume loop measurements in both the right and left ventricles. RESULTS Ees and normalised Ees (Ees/Ea) calculated from the pressure method performed better than ones from the volume method in correlation with mean pulmonary arterial pressure and mean right arterial pressure. The cutoff sets of Ees and Ees/Ea were capable of grouping pulmonary hypertension patients which were well supported by their significant correlation with several key right ventricular hemodynamic parameters. Additionally, the normalised Ees was able to reflect the changes in left ventricular function during the deterioration of PAH. CONCLUSION Ees and Ees/Ea are promising independent reference parameters for assessing ventricular function in progressing PAH patients.
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Affiliation(s)
- Xiaoke Shang
- Department of Internal Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Changdong Zhang
- Department of Internal Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Mei Liu
- Intensive Care Unit, Wuhan NO. 1 Hospital, Wuhan, China
| | - Rong Lu
- Intensive Care Unit, Wuhan NO. 1 Hospital, Wuhan, China
| | - Yanggan Wang
- Department of Internal Medicine, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
- Medical Research Institute of Wuhan University, Wuhan University, Wuhan, China
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