Asymmetric right ventricular myocardial work correlates with gold standard measurements of cardiac function in pulmonary hypertension.

Autor: Diab SG; Department of Paediatric Cardiology Oslo University Hospital Oslo Norway.; Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway., Ebata R; Department of Paediatrics, Graduate School of Medicine Chiba University Chiba Japan., Mroczek D; Division of Cardiology, Labatt Family Heart Centre The Hospital for Sick Children Toronto Ontario Canada., Hui W; Division of Cardiology, Labatt Family Heart Centre The Hospital for Sick Children Toronto Ontario Canada., Remme EW; Institute for Surgical Research Oslo University Hospital Oslo Norway., Möller T; Department of Paediatric Cardiology Oslo University Hospital Oslo Norway., Friedberg MK; Division of Cardiology, Labatt Family Heart Centre The Hospital for Sick Children Toronto Ontario Canada.
Jazyk: angličtina
Zdroj: Pulmonary circulation [Pulm Circ] 2024 Nov 17; Vol. 14 (4), pp. e70014. Date of Electronic Publication: 2024 Nov 17 (Print Publication: 2024).
DOI: 10.1002/pul2.70014
Abstrakt: Right ventricular (RV) (dys)function determines outcomes in pulmonary hypertension (PH). We previously found that asymmetric RV myocardial work (MW) corresponds with inefficient RV function in experimental PH models. We therefore aimed to investigate regional distribution of RV MW and its correlation with catheter hemodynamics in children with PH. RV MW was calculated by longitudinal strain and simultaneous catheter pressure measurements in 14 patients with PH. Wasted MW was defined as the ratio of inappropriate myocardial lengthening to favorable shortening work. Segment-wise and averaged MW and wasted MW were evaluated at baseline and during pulmonary vasodilation therapy with oxygen and nitric oxide, and their relationship to hemodynamic measurements was analyzed. We found that MW was higher for the lateral wall than the septum: 1013 ± 374 mmHg · % versus 532 ± 190 mmHg · % at baseline. Wasted MW ratio did not differ significantly between wall regions. Pulmonary vasodilators slightly reduced mean pulmonary artery pressure and was accompanied by a more symmetrical MW distribution. Averaged MW correlated with the rate of RV pressure development (dP/dt maximum) and decay (dP/dt minimum) at all conditions ( p  ≤  0.047). The results suggest that MW contribute to, and may be used as a marker of, systolic and diastolic efficiency in the PH RV.
Competing Interests: The authors declare no conflict of interest.
(© 2024 The Author(s). Pulmonary Circulation published by John Wiley & Sons Ltd on behalf of Pulmonary Vascular Research Institute.)
Databáze: MEDLINE
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