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Fukui M, Sorajja P, Hashimoto G, Lopes BBC, Stanberry LI, Garcia S, Gössl M, Cheng V, Enriquez-Sarano M, Bapat VN, Lesser JR, Cavalcante JL. Right ventricular dysfunction by computed tomography associates with outcomes in severe aortic stenosis patients undergoing transcatheter aortic valve replacement. J Cardiovasc Comput Tomogr 2021:S1934-5925(21)00465-2. [PMID: 34794909 DOI: 10.1016/j.jcct.2021.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/03/2021] [Accepted: 11/10/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although cardiac computed tomography angiography (CCTA) assessment of right ventricular dysfunction (RVD) is feasible, the incremental prognostic value remains uncertain in patients undergoing transcatheter aortic valve replacement (TAVR) evaluation. This study sought to determine the incremental clinical utility of RVD identification by CCTA while accounting for clinical and echocardiographic parameters. METHODS Patients who underwent multiphasic ECG-gated functional CCTA using dual-source system for routine TAVR planning were evaluated. Biphasic contrast protocol injection allowed for biventricular contrast enhancement. CCTA-based RVD was defined as right ventricular ejection fraction (RVEF) < 50%. The association of CCTA-RVD with all-cause mortality and the composite outcome of death or heart failure hospitalization after TAVR was evaluated and examined for its incremental utility beyond clinical risk assessment and echocardiographic parameters. RESULTS A total of 502 patients were included (median [IQR] age, 82 [77 to 87] years; 56% men) with a median follow-up of 22 [16 to 32] months. Importantly, 126 (25%) patients were identified as having RVD by CCTA that was not identified by echocardiography. CCTA-defined RVD predicted death and the composite outcome in both univariate analyses (HR for mortality, 2.15; 95% CI, 1.44-3.22; p < 0.001; HR for composite outcome, 2.11; 95% CI, 1.48-3.01; p < 0.001) and in multivariate models that included clinical risk factors and echocardiographic findings (HR for mortality, 1.74; 95% CI, 1.11-2.74; p = 0.02; HR for composite outcome, 1.63; 95% CI, 1.09-2.44; p = 0.02). CONCLUSIONS Functional CCTA assessment pre-TAVR correctly identified 25% of patients with RVD that was not evident on 2D echocardiography. The presence of RVD on CCTA independently associates with clinical outcomes post-TAVR.
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Clemente EA, Casares ÁP, Frontera PR, Calvar JMC, de Toledo JS. Finding the Optimal Timing for Repair of Standard Tetralogy of Fallot: Analysis of Cardiac Magnetic Resonance and Echocardiography Parameters Related to Intermediate Term Outcomes in a Pediatric Population. Pediatr Cardiol 2021; 42:1324-1333. [PMID: 33934202 DOI: 10.1007/s00246-021-02615-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Right ventricular (RV) dilatation is the determining prognostic factor in the long-term follow up of patients with repaired Tetralogy of Fallot (TOF). The objective of this study is to analyze whether the results vary depending on the timing of the complete repair and on the surgical technique applied. MATERIAL-METHODS This is a retrospective longitudinal study in which patients with standard TOF were divided into 3 groups depending on their age at surgical repair: group 1 = Early repair (n = 12,1-8 months), group 2 = Late repair (n = 26, > 8 months), and group 3 = Late repair with previous palliative surgery (n = 17, > 8 months). Clinical, echocardiographic and cardiac magnetic resonance (CMR) data from patients that had received complete reparative surgery in our institution from January 2000 to March 2014 were analyzed and compared. RESULTS 55 patients with echocardiogram and CMR studies (13.39 ± 3.59 years) were reviewed. All patients had at least moderate pulmonary regurgitation (PR). We observed a positive correlation between PR and right ventricular end-diastolic volume (r2 = 0.418; p = 0,004). Group 3 had more severe right ventricular dilatation than patients in groups 1 and 2 (p = 0.001). No differences in right ventricular end-diastolic volume, PR, and pulmonary trunk dimensions were observed between groups 1 and 2. Patients in group 3 had a longer hospital stay. CONCLUSIONS Although all patients from our cohort had significant PR, age at surgery was not related to RV or pulmonary trunk dilatation. Previous palliative surgery was associated with more severe right ventricular dilatation and longer hospital stays. No differences were observed between early and late repair groups. Our study suggests that postponing TOF repair to a late stage does not improve the degree of PR or long-term morbidity from RV dilatation. Palliative surgery should be avoided if possible.
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Affiliation(s)
- Esther Aurensanz Clemente
- Pediatric Cardiology Department, Sant Joan de Déu Children Hospital, C/Passeig Sant Joan de Deu, s/n, 08950, Esplugues, Barcelona, Spain.
| | - Álex Pérez Casares
- Pediatric Cardiology Department, Sant Joan de Déu Children Hospital, C/Passeig Sant Joan de Deu, s/n, 08950, Esplugues, Barcelona, Spain.,CMR Imaging Department, Sant Joan de Déu Children Hospital, Barcelona, Spain
| | - Pablo Ruiz Frontera
- Intensive Care Unit, Cardiac Institute Quiron Salud Teknon, Barcelona, Spain
| | | | - Joan Sanchez de Toledo
- Pediatric Cardiology Department, Sant Joan de Déu Children Hospital, C/Passeig Sant Joan de Deu, s/n, 08950, Esplugues, Barcelona, Spain
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Bragança B, Trêpa M, Santos R, Silveira I, Fontes-Oliveira M, Sousa MJ, Reis H, Torres S, Santos M. Echocardiographic Assessment of Right Ventriculo-arterial Coupling: Clinical Correlates and Prognostic Impact in Heart Failure Patients Undergoing Cardiac Resynchronization Therapy. J Cardiovasc Imaging 2020; 28:109-120. [PMID: 32052609 PMCID: PMC7114448 DOI: 10.4250/jcvi.2019.0094] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 11/30/2019] [Accepted: 12/17/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Right ventriculo-arterial coupling (RV-PA) can be estimated by echocardiography using the ratio between tricuspid annular plane systolic excursion (TAPSE) and pulmonary artery systolic pressure (PASP) and it has prognostic value in the general heart failure (HF) population. We aimed to study the clinical correlates and prognostic value of RV-PA in HF patients undergoing cardiac resynchronization therapy (CRT). METHODS We retrospectively studied 70 HF patients undergoing CRT implantation. RESULTS RV-PA coupling was estimated by TAPSE/PASP ratio using baseline echocardiography. Non-response to CRT was defined as improvement of left ventricular ejection fraction < 5% in a follow-up echo 6-12 months after CRT. Those with lower TAPSE/PASP ratios (worse RV-PA coupling) had higher NT-proBNP concentrations and increased E/e' ratio. TAPSE/PASP ratio and PASP, but not TAPSE, predicted nonresponse to CRT with TAPSE/PASP ratio showing the best discriminative ability with a sensitivity of 76% and specificity of 71%. Among these parameters, PASP independently predicted all-cause mortality. CONCLUSIONS RV-PA coupling estimated by TAPSE/PASP ratio was associated with established prognostic markers in HF. It numerically outperformed PASP and TAPSE in predicting the response to CRT. Our data suggest that this simple and widely available echocardiographic parameter conveys significant pathophysiological and prognostic meaning in HF patients undergoing CRT.
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Affiliation(s)
- Bruno Bragança
- Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal
| | - Maria Trêpa
- Centro Hospitalar Universitário do Porto, Porto, Portugal.
| | - Raquel Santos
- Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Inês Silveira
- Centro Hospitalar Universitário do Porto, Porto, Portugal
| | | | | | - Hipólito Reis
- Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Severo Torres
- Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Mário Santos
- Centro Hospitalar Universitário do Porto, Porto, Portugal
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Mahran Y, Schueler R, Weber M, Pizarro C, Nickenig G, Skowasch D, Hammerstingl C. Noninvasive model including right ventricular speckle tracking for the evaluation of pulmonary hypertension. World J Cardiol 2016; 8:472-480. [PMID: 27621775 PMCID: PMC4997528 DOI: 10.4330/wjc.v8.i8.472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 04/29/2016] [Accepted: 07/13/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To find parameters from transthorathic echocardiography (TTE) including speckle-tracking (ST) analysis of the right ventricle (RV) to identify precapillary pulmonary hypertension (PH).
METHODS Forty-four patients with suspected PH undergoing right heart catheterization (RHC) were consecutively included (mean age 63.1 ± 14 years, 61% male gender). All patients underwent standardized TTE including ST analysis of the RV. Based on the subsequent TTE-derived measurements, the presence of PH was assessed: Left ventricular ejection fraction (LVEF) was calculated by Simpsons rule from 4Ch. Systolic pulmonary artery pressure (sPAP) was assessed with continuous wave Doppler of systolic tricuspid regurgitant velocity and regarded raised with values ≥ 30 mmHg as a surrogate parameter for RA pressure. A concomitantly elevated PCWP was considered a means to discriminate between the precapillary and postcapillary form of PH. PCWP was considered elevated when the E/e’ ratio was > 12 as a surrogate for LV diastolic pressure. E/e’ ratio was measured by gauging systolic and diastolic velocities of the lateral and septal mitral valve annulus using TDI mode. The results were then averaged with conventional measurement of mitral valve inflow. Furthermore, functional testing with six minutes walking distance (6MWD), ECG-RV stress signs, NT pro-BNP and other laboratory values were assessed.
RESULTS PH was confirmed in 34 patients (precapillary PH, n = 15, postcapillary PH, n = 19). TTE showed significant differences in E/e’ ratio (precapillary PH: 12.3 ± 4.4, postcapillary PH: 17.3 ± 10.3, no PH: 12.1 ± 4.5, P = 0.02), LV volumes (ESV: 25.0 ± 15.0 mL, 49.9 ± 29.5 mL, 32.2 ± 13.6 mL, P = 0.027; EDV: 73.6 ± 24.0 mL, 110.6 ± 31.8 mL, 87.8 ± 33.0 mL, P = 0.021) and systolic pulmonary arterial pressure (sPAP: 61.2 ± 22.3 mmHg, 53.6 ± 20.1 mmHg, 31.2 ± 24.6 mmHg, P = 0.001). STRV analysis showed significant differences for apical RV longitudinal strain (RVAS: -7.5% ± 5.6%, -13.3% ± 4.3%, -14.3% ± 6.3%, P = 0.03). NT pro-BNP was higher in patients with postcapillary PH (4677.0 ± 7764.1 pg/mL, precapillary PH: 1980.3 ± 3432.1 pg/mL, no PH: 367.5 ± 420.4 pg/mL, P = 0.03). Patients with precapillary PH presented significantly more often with ECG RV-stress signs (P = 0.001). Receiver operating characteristics curve analyses displayed the most significant area under the curve (AUC) for RVAS (cut-off < -6.5%, AUC 0.91, P < 0.001), sPAP (cut-off > 33 mmHg, AUC 0.86, P < 0.001) and ECG RV stress signs (AUC 0.83, P < 0.001). The combination of these parameters had a sensitivity of 82.8% and a specificity of 17.2% to detect precapillary PH.
CONCLUSION The combination of non-invasive measurements allows feasible assessment of PH and seems beneficial for the differentiation between the pre- and postcapillary form of this disease.
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Khani M, Hosseintash M, Foroughi M, Naderian M, Khaheshi I. Assessment of the effect of off-pump coronary artery bypass (OPCAB) surgery on right ventricle function using strain and strain rate imaging. Cardiovasc Diagn Ther 2016; 6:138-43. [PMID: 27054103 DOI: 10.21037/cdt.2016.02.03] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Right ventricle function significantly decreases after coronary artery bypass surgery; as one of the likely causes, such a condition is attributed to the use of cardiopulmonary pump (CPB). Because nowadays there is a tendency toward increasing use of off-pump coronary artery bypass (OPCAB) surgery, this study was conducted to evaluate the right ventricle function after this type of surgery using strain and strain rate imaging (SRI) echocardiography. METHODS This study was conducted on 30 patients, candidate for elective OPCAB surgery, between 2011 and 2012. Standard echocardiography was performed before the surgery and the right ventricle function was examined using strain and SRI echocardiography. Then patient underwent surgery, 6 days and 3 months after surgery they underwent echocardiography again and the results obtained from the three stages were compared with each other. RESULTS Participants included 30 patients (23 males and 7 females) with a mean age of 66±11 years. Compared to the prior of the surgery, 6 days and 3 months after the surgery there was a significant decrease in tricuspid annular plane systolic excursion (TAPSE), tissue Doppler imaging (TDI) at the lateral annulus of tricuspid valve, and strain and SRI of right ventricle. However, the values obtained 3 months after surgery were significantly higher than those obtained after 6 days. In other words, the right ventricle function 6 days after the surgery had dropped, however some of the values recovered 3 months after the surgery. CONCLUSIONS The findings of this study are consistent with other studies in this field and showed that after coronary artery surgery a decline occurs in right ventricular function. However, more detailed quantitative strain and SRI parameters which were measured in our study showed that at the early days after the OPCAB surgery there is a decline in the right ventricle function which is relatively reversible at longer intervals (3 months after surgery).
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Affiliation(s)
- Mohammad Khani
- 1 Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; 2 Cardiovascular Research Center, Department of cardiovascular surgery, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; 3 Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Hosseintash
- 1 Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; 2 Cardiovascular Research Center, Department of cardiovascular surgery, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; 3 Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnoosh Foroughi
- 1 Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; 2 Cardiovascular Research Center, Department of cardiovascular surgery, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; 3 Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Naderian
- 1 Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; 2 Cardiovascular Research Center, Department of cardiovascular surgery, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; 3 Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Isa Khaheshi
- 1 Cardiovascular Research Center, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; 2 Cardiovascular Research Center, Department of cardiovascular surgery, Modarres hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; 3 Students Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
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Numano F, Shimizu C, Tremoulet AH, Dyar D, Burns JC, Printz BF. Pulmonary Artery Dilation and Right Ventricular Function in Acute Kawasaki Disease. Pediatr Cardiol 2016; 37:482-90. [PMID: 26681305 DOI: 10.1007/s00246-015-1303-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 11/02/2015] [Indexed: 10/22/2022]
Abstract
Coronary artery inflammation and aneurysm formation are the most common complications of Kawasaki disease (KD). Valvulitis and myocarditis are also well described and may lead to valvar regurgitation and left ventricular dysfunction. However, functional changes in the right heart have rarely been reported. We noted several acute KD patients with dilated pulmonary arteries (PA) and thus sought to systematically characterize PA size and right-heart function in an unselected cohort of KD patients cared for at a single clinical center. Clinical, laboratory, and echocardiographic data from 143 acute KD subjects were analyzed. PA dilation was documented in 23 subjects (16.1 %); these subjects had higher median right ventricle myocardial performance index (RV MPI), higher ratio of early tricuspid inflow velocity to tricuspid annular early diastolic velocity (TV E/e'), and lower median TV e' velocity compared to the non-PA dilation group (0.50 vs 0.38 p < 0.01, 4.2 vs 3.6 p < 0.05, and 13.5 vs 15.2 cm/s p < 0.01, respectively). Almost all subjects with PA dilation had improved PA Z-score, RV MPI, and TV E/e' in the subacute phase (p < 0.01). There were no significant differences in indices of left ventricle function between PA dilation group and non-PA dilation group. In summary, PA dilation was documented in 16 % of acute KD subjects. These subjects were more likely to have echocardiographic indices consistent with isolated RV dysfunction that improved in the subacute phase. The long-term consequence of these findings will require longitudinal studies of this patient population.
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Affiliation(s)
- Fujito Numano
- Departments of Pediatrics, San Diego School of Medicine, University of California, San Diego, USA. .,Department of Pediatrics, UCSD School of Medicine, Kawasaki Disease Research Center, 9500 Gilman Dr., La Jolla, CA, 92093-0641, USA.
| | - Chisato Shimizu
- Departments of Pediatrics, San Diego School of Medicine, University of California, San Diego, USA
| | - Adriana H Tremoulet
- Departments of Pediatrics, San Diego School of Medicine, University of California, San Diego, USA.,Rady Children's Hospital San Diego, San Diego, USA
| | - Dan Dyar
- Rady Children's Hospital San Diego, San Diego, USA
| | - Jane C Burns
- Departments of Pediatrics, San Diego School of Medicine, University of California, San Diego, USA.,Rady Children's Hospital San Diego, San Diego, USA
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Scarsini R, Prioli MA, Milano EG, Castellani C, Pesarini G, Assael BM, Vassanelli C, Ribichini FL. Hemodynamic predictors of long term survival in end stage cystic fibrosis. Int J Cardiol 2015; 202:221-5. [PMID: 26397415 DOI: 10.1016/j.ijcard.2015.09.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 09/08/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Pulmonary hypertension (PH) is often found in cystic fibrosis (CF) patients affected by end-stage lung disease but its impact on outcome remains unclear. Pulmonary arterial compliance (PAC) is an important determinant of right ventricle (RV) workload and it is a strong predictor of survival in other forms of PH. The aim of this study is to investigate whether PAC is a predictor of long-term prognosis in a population of CF patients affected by advanced lung disease. METHODS Between 2000 and 2014, 178 patients with CF have been evaluated for lung transplantation in our CF Center. Right heart catheterization (RHC) and follow up data were retrievable and analyzed in 141 of them. PAC was defined as the ratio between stroke volume (SV) and pulse pressure (PP) at heart catheterization. The association of PAC with survival was tested at 4 years and compared to other hemodynamic parameters. RESULTS PH prevalence was 56.4%. Most patients had mild elevation of pulmonary artery pressure (PAP). No difference in mortality was observed in patients with PH compared to patients with normal PAP (HR 0.95: 95% CI 0.49-1.89, p=0.89). At receiver operating characteristic curve (ROC) analysis, the optimal prognostic cut-off point of PAC was 1.95 ml/mmHg. An impaired PAC (≤1.95 ml/mmHg) was a strong independent predictor of long-term mortality (HR 3.44: 95% CI 1.51-7.85: p=0.003). CONCLUSIONS Impaired PAC is associated with poor prognosis in CF patients awaiting lung transplantation. Other traditional hemodynamic parameters add no prognostic information.
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Affiliation(s)
- Roberto Scarsini
- Department of Medicine, Section of Cardiology, University of Verona, Verona, Italy.
| | - Maria A Prioli
- Department of Medicine, Section of Cardiology, University of Verona, Verona, Italy
| | - Elena G Milano
- Department of Medicine, Section of Cardiology, University of Verona, Verona, Italy
| | | | - Gabriele Pesarini
- Department of Medicine, Section of Cardiology, University of Verona, Verona, Italy
| | | | - Corrado Vassanelli
- Department of Medicine, Section of Cardiology, University of Verona, Verona, Italy
| | - Flavio L Ribichini
- Department of Medicine, Section of Cardiology, University of Verona, Verona, Italy
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Martín M, Corros C, García-Campos A, Rodríguez ML, Colunga S, Rozado J, Barriales V, de la Hera J, Santamarta E. The forgotten valvulopathy and the forgotten ventricle? Int J Cardiol 2014; 172:e30. [PMID: 24438923 DOI: 10.1016/j.ijcard.2013.12.089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2013] [Accepted: 12/21/2013] [Indexed: 11/25/2022]
Affiliation(s)
- María Martín
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
| | - Cecilia Corros
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Ana García-Campos
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - María Luisa Rodríguez
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Santiago Colunga
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - José Rozado
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Vicente Barriales
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Jesús de la Hera
- Cardiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Elena Santamarta
- Radiology Department, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
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Leite-Moreira AF, Lourenço AP, Balligand JL, Bauersachs J, Clerk A, De Windt LJ, Heymans S, Hilfiker-Kleiner D, Hirsch E, Iaccarino G, Kaminski KA, Knöll R, Mayr M, Tarone G, Thum T, Tocchetti CG. ESC Working Group on Myocardial Function Position Paper: how to study the right ventricle in experimental models. Eur J Heart Fail 2014; 16:509-18. [PMID: 24574252 DOI: 10.1002/ejhf.66] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 11/25/2013] [Accepted: 01/17/2014] [Indexed: 11/09/2022] Open
Abstract
The right ventricle has become an increasing focus in cardiovascular research. In this position paper, we give a brief overview of the specific pathophysiological features of the right ventricle, with particular emphasis on functional and molecular modifications as well as therapeutic strategies in chronic overload, highlighting the differences from the left ventricle. Importantly, we put together recommendations on promising topics of research in the field, experimental study design, and functional evaluation of the right ventricle in experimental models, from non-invasive methodologies to haemodynamic evaluation and ex vivo set-ups.
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Affiliation(s)
- Adelino F Leite-Moreira
- Department of Physiology and Cardiothoracic Surgery, Faculty of Medicine, University of Porto, Al. Prof. Hernani Monteiro, 4200 319, Porto, Portugal
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Wang J, Gu P. Value of strain rate imaging in research of longitudinal function of the right ventricle in patients with liver cirrhosis. Shijie Huaren Xiaohua Zazhi 2013; 21:1131-1135. [DOI: 10.11569/wcjd.v21.i12.1131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To assess the value of ultrasound strain rate imaging in research of longitudinal function of the right ventricle (RV) in patients with liver cirrhosis.
METHODS: Sixty-two patients with liver cirrhosis were selected as an experimental group and were divided into three subgroups based on the Child-Hugh grade: level A (n = 20), level B (n = 22) and level C (n = 20), and another 30 healthy volunteers were included in a control group. The systolic peak strain rate (SRS), early diastolic peak strain rate (SRE) and atrial systole peak strain rate (SRA) of three segments of the RV free wall were measured. Tissue Doppler imaging was used to measure the Em and Am at the posterior tricuspid annuli.
RESULTS: The SRS, SRA and SRE of the base segment of the RV free wall were significantly decreased in the experimental group compared to the control group (-1.93 s-1 ± 0.11 s-1vs -2.51 s-1 ± 0.88 s-1, 1.43 s-1 ± 0.11 s-1vs 1.59 s-1 ± 0.04 s-1, 2.17 s-1 ± 0.08 s-1vs 2.37 s-1 ± 0.13 s-1; all P < 0.05). The SRS, SRE and SRA of the middle segment of the RV free wall were also significantly decreased in the experimental group compared to the control group (-1.69 s-1 ± 0.56 s-1vs -1.97 s-1 ± 0.60 s-1, 1.38 s-1 ± 0.38 s-1 vs 2.26 s-1 ± 0.70 s-1, 1.36 s-1 ± 0.88s-1vs 1.49 s-1 ± 0.04 s-1; all P < 0.05). The SRS, SRE and SRA of the apex cordis segment of the RV free wall were also significantly decreased in the experimental group compared to the control group (-1.36 s-1 ± 0.31 s-1vs -2.37 s-1 ± 0.78 s-1, 1.47 s-1 ± 0.05 s-1vs 1.79 s-1 ± 0.12 s-1, 1.22 s-1 ± 0.05 s-1vs 1.37 s-1 ± 0.10 s-1; all P < 0.05). The peak early diastolic velocity and peak late diastolic velocity at the posterior tricuspid annuli in the experimental group were markedly decreased compared with those in the control group (0.12 m/s ± 0.03 m/s vs 0.19 m/s ± 0.02 m/s, 0.15 m/s ± 0.04 m/s vs 0.17 m/s ± 0.02 m/s, both P < 0.05).
CONCLUSION: Ultrasonic strain rate imaging allows for more accurate evaluation of longitudinal systolic and diastolic function of the RV in patients with liver cirrhosis and can help evaluate therapeutic effects and prognosis.
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