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Deaconu S, Deaconu A, Scarlatescu A, Petre I, Onciul S, Vijiiac A, Zamfir D, Marascu G, Iorgulescu C, Radu AD, Bogdan S, Vatasescu R. Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy. J Clin Med 2021; 10:jcm10112442. [PMID: 34072825 PMCID: PMC8198639 DOI: 10.3390/jcm10112442] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulmonary arterial systolic pressure (PASP) has prognostic significance in patients undergoing cardiac resynchronization therapy (CRT). METHODS Patients undergoing CRT were prospectively included. The primary endpoint was adverse cardiovascular events (death and HF-related hospitalizations). RV global longitudinal strain (RVGLS) and RV free wall strain (RVfwS) were measured by speckle tracking and indexed to echocardiographic estimated PASP. RESULTS A total of 54 patients (64.0 ± 13.8 years; 58% male) were included. After 33 ± 12.9 months, the primary endpoint occurred in 18 patients. Baseline RVGLS/PASP and RVfwS/PASP showed good discriminative ability for response to CRT (AUC = 0.88, 95% CI (0.74-1) and AUC = 0.87, 95% CI (0.77-1)). RVGLS/PASP and RVfwS/PASP were significantly associated with high risk of events at univariate analysis (HR 0.039, 95% CI (0.001-0.8) p < 0.05, respectively HR = 0.049, 95% CI (0.0033-0.72), p < 0.05). Upon multivariate Cox regression analysis, RVGLS/PASP and RVfwS/PASP remained associated with high risk of events (HR 0.018, 95% CI (0.0005-0.64), p = 0.02 and HR 0.015, 95% CI (0.0004-0.524), p = 0.01) after correction for gender, etiology, QRS duration and morphology. Conclusions: Indexing RV longitudinal strain (global and free wall) by PASP provides a parameter, which independently identifies patients with high risk of cardiovascular events and predicts non-response to CRT.
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Affiliation(s)
- Silvia Deaconu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.D.); (I.P.); (S.O.); (A.V.); (G.M.); (A.D.R.); (S.B.); (R.V.)
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
| | - Alexandru Deaconu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.D.); (I.P.); (S.O.); (A.V.); (G.M.); (A.D.R.); (S.B.); (R.V.)
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
- Correspondence: ; Tel.: +40-727-403-885
| | - Alina Scarlatescu
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
| | - Ioana Petre
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.D.); (I.P.); (S.O.); (A.V.); (G.M.); (A.D.R.); (S.B.); (R.V.)
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
| | - Sebastian Onciul
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.D.); (I.P.); (S.O.); (A.V.); (G.M.); (A.D.R.); (S.B.); (R.V.)
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
| | - Aura Vijiiac
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.D.); (I.P.); (S.O.); (A.V.); (G.M.); (A.D.R.); (S.B.); (R.V.)
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
| | - Diana Zamfir
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
| | - Gabriela Marascu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.D.); (I.P.); (S.O.); (A.V.); (G.M.); (A.D.R.); (S.B.); (R.V.)
| | - Corneliu Iorgulescu
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
| | - Andrei Dan Radu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.D.); (I.P.); (S.O.); (A.V.); (G.M.); (A.D.R.); (S.B.); (R.V.)
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
| | - Stefan Bogdan
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.D.); (I.P.); (S.O.); (A.V.); (G.M.); (A.D.R.); (S.B.); (R.V.)
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
| | - Radu Vatasescu
- Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (S.D.); (I.P.); (S.O.); (A.V.); (G.M.); (A.D.R.); (S.B.); (R.V.)
- Cardiology Department, Clinical Emergency Hospital, 014461 Bucharest, Romania; (A.S.); (D.Z.); (C.I.)
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