Echocardiographic estimation of right ventricular diastolic stiffness based on pulmonary regurgitant velocity waveform analysis in precapillary pulmonary hypertension.

Autor: Nagai Y; Graduate School of Health Sciences, Hokkaido University, N12, W5, Kita-ku, Sapporo, 060-0812, Japan., Murayama M; Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, N12, W5, Kita-ku, Sapporo, 060-0812, Japan., Kaga S; Department of Medical Laboratory Science, Faculty of Health Sciences, Hokkaido University, N12, W5, Kita-ku, Sapporo, 060-0812, Japan. sanae@med.hokudai.ac.jp., Shima H; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, N14, W5, Kita-ku, Sapporo, 060-8648, Japan., Tsuneta S; Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, N14 W5, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan., Yokoyama S; Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan., Nishino H; Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan., Goto M; Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan., Suzuki Y; Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan., Yanagi Y; Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan., Ishizaka S; Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan.; Department of Cardiovascular Medicine, Faculty of Medicine, Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Japan., Iwano H; Diagnostic Center for Sonography, Hokkaido University Hospital, N14, W5, Kita-ku, Sapporo, 060-8648, Japan.; Division of Cardiology, Teine Keijinkai Hospital, 1-40, Maeda 1-jo 12-chome Teine-ku, Sapporo, 006-8555, Japan., Nakamura J; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, N14, W5, Kita-ku, Sapporo, 060-8648, Japan., Sato T; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, N14, W5, Kita-ku, Sapporo, 060-8648, Japan.; Division of Respiratory and Cardiovascular Innovative Research, Faculty of Medicine, Hokkaido University, N14, W5, Kita-ku, Sapporo, 060-8648, Japan., Tsujino I; Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, N14, W5, Kita-ku, Sapporo, 060-8648, Japan.; Division of Respiratory and Cardiovascular Innovative Research, Faculty of Medicine, Hokkaido University, N14, W5, Kita-ku, Sapporo, 060-8648, Japan.
Jazyk: angličtina
Zdroj: The international journal of cardiovascular imaging [Int J Cardiovasc Imaging] 2024 May; Vol. 40 (5), pp. 1123-1134. Date of Electronic Publication: 2024 Mar 27.
DOI: 10.1007/s10554-024-03083-1
Abstrakt: Right ventricular (RV) diastolic stiffness is an independent predictor of survival and is strongly associated with disease severity in patients with precapillary pulmonary hypertension (PH). Therefore, a fully validated echocardiographic method for assessing RV diastolic stiffness needs to be established. This study aimed to compare echocardiography-derived RV diastolic stiffness and invasively measured pressure-volume loop-derived RV diastolic stiffness in patients with precapillary PH. We studied 50 consecutive patients with suspected or confirmed precapillary PH who underwent cardiac catheterization, magnetic resonance imaging, and echocardiography within a 1-week interval. Single-beat RV pressure-volume analysis was performed to determine the gold standard for RV diastolic stiffness. Elevated RV end-diastolic pressure (RVEDP) was defined as RVEDP ≥ 8 mmHg. Using continuous-wave Doppler and M-mode echocardiography, an echocardiographic index of RV diastolic stiffness was calculated as the ratio of the atrial-systolic descent of the pulmonary artery-RV pressure gradient derived from pulmonary regurgitant velocity (PRPGD AC ) to the tricuspid annular plane movement during atrial contraction (TAPM AC ). PRPGD AC /TAPM AC showed significant correlation with β (r = 0.54, p < 0.001) and RVEDP (r = 0.61, p < 0.001). A cut-off value of 0.74 mmHg/mm for PRPGD AC /TAPM AC showed 83% sensitivity and 93% specificity for identifying elevated RVEDP. Multivariate analyses indicated that PRPGD AC /TAPM AC was independently associated with disease severity in patients with precapillary PH, including substantial PH symptoms, stroke volume index, right atrial size, and pressure. PRPGD AC /TAPM AC , based on pulmonary regurgitation velocity waveform analysis, is useful for the noninvasive assessment of RV diastolic stiffness and is associated with prognostic risk factors in precapillary PH.
(© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)
Databáze: MEDLINE
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