Clinical Surrogates of Right Ventricular-Pulmonary Arterial Uncoupling
| Autor: | C.G. Ireland, Ami A. Shah, Rachel L. Damico, Ryan J. Tedford, Todd M. Kolb, Monica Mukherjee, Steven Hsu, Stephen C. Mathai, Paul M. Hassoun, David A. Kass, Stefan L. Zimmerman, F. M. Wigley |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Transplantation medicine.medical_specialty Future studies Supine position medicine.diagnostic_test business.industry Gold standard (test) medicine.disease Pulmonary hypertension Elastance Contractility Cardiac magnetic resonance imaging Internal medicine Arterial elastance medicine Cardiology Surgery Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Journal of Heart and Lung Transplantation. 38:S95-S96 |
| ISSN: | 1053-2498 |
| Popis: | Purpose Right ventricular (RV) function is best represented by the ratio of RV contractility to pulmonary arterial (PA) load (RV-PA coupling). Gold standard measurement of RV-PA coupling, using multi-beat pressure-volume (P-V) loop to obtain the ratio of end-systolic elastance (Ees) to effective arterial elastance (Ea), is costly and invasive. Therefore, we sought to identify clinical surrogates of reduced Ees/Ea and RV-PA uncoupling. Methods We prospectively studied 35 patients suspected to have pulmonary hypertension (PH) with same day echocardiography, cardiac magnetic resonance imaging (CMR), right heart catheterization, and supine bicycle submaximal cardiopulmonary exercise testing. Multi-beat RV P-V loop measurements were also performed. Ees/Ea Results Of 35 patients, 26 had resting PH while 9 did not (20/26 had group I PH). Average age was 57±13 years; 30 were women. Compared with baseline Ees/Ea ≥ 1.0, Ees/Ea Conclusion Readily attainable clinical variables correspond to the gold standard Ees/Ea. We identified a novel parameter, exercise change in ΔESV/ΔESP, a marker of RV reserve, which had the best ability to predict RV-PA uncoupling. Future studies will investigate RV ΔESV/ΔESP and other markers of RV reserve. |
| Databáze: | OpenAIRE |
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