Impact of right ventricular dysfunction and end-diastolic pulmonary artery pressure estimated from analysis of tricuspid regurgitant velocity spectrum in patients with preserved ejection fraction
| Autor: | Livia Kapusta, Guy Baruch, Simon Biner, Meirav Ingbir, Lorin Arie Schwartz, Ehud Rothschild, Galit Aviram, Yan Topilsky, Ido Nachmany, Gad Keren |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Heart Ventricles Ventricular Dysfunction Right Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Diastole Hemodynamics Blood Pressure Pulmonary Artery 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine.artery medicine Humans Radiology Nuclear Medicine and imaging Systole Aged Retrospective Studies Aged 80 and over Ejection fraction business.industry Stroke Volume General Medicine Stroke volume Middle Aged Prognosis Tricuspid Valve Insufficiency medicine.anatomical_structure Echocardiography Pulmonary valve Pulmonary artery Cardiology Female Cardiology and Cardiovascular Medicine Heart failure with preserved ejection fraction business Blood Flow Velocity |
| Zdroj: | European Heart Journal Cardiovascular Imaging, 20, 446-454 European Heart Journal Cardiovascular Imaging, 20, 4, pp. 446-454 |
| ISSN: | 2047-2404 |
| Popis: | Item does not contain fulltext AIMS: We aimed to analyse the association between right haemodynamic parameters, right ventricular (RV) dysfunction parameters, and outcomes in patients with preserved ejection fraction (EF). METHODS AND RESULTS: Retrospective analysis of right haemodynamic (systolic pulmonary pressure and end-diastolic pulmonary pressure based on tricuspid regurgitation (TR) velocity at pulmonary valve opening time), and RV parameters including size (end-diastolic and end-systolic area), function (RV fractional area change, Tei index, Tricuspid Annular Plane Systolic Excursion, and speckle tracking derived free wall strain), from 557 consecutive patients with preserved EF [EF >/= 50%; age 64.9 + 20; 52% female; co-morbidity Charlson index 4.7 (2.9, 6.4)]. All cause and cardiac mortality were retrospectively analysed and correlated to echo haemodynamic and co-morbid parameters. TR velocity at pulmonary valve opening time and calculated end-diastolic pulmonary artery pressure were obtainable in 71% of patients. The best haemodynamic univariate predictor of mortality was calculated end-diastolic pulmonary artery pressure [hazard ratio 1.06 (1.04-1.07); P < 0.0001], superior to TR peak velocity and systolic pulmonary artery pressure. Elevated end-diastolic pulmonary artery pressure was associated with all cause and cardiac mortality even when adjusted for all significant clinical (age, gender, and Charlson index), and echo (stroke volume index, left atrial volume index, systolic pulmonary pressure, E/e', and Tei index) parameters. Tei index was superior to all other RV functional parameters (P < 0.05 for all parameters). CONCLUSION: TR velocity at pulmonary valve opening time and calculated end-diastolic pulmonary artery pressure are obtainable in most patients, and add prognostic information on top of clinical and routine haemodynamic and diastolic parameters. |
| Databáze: | OpenAIRE |
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