Right Ventricular Strain Curve Morphology and Outcome in Idiopathic Pulmonary Arterial Hypertension
| Autor: | Antonella Pascaretta, Francesco Ciciarello, Roberto Badagliacca, Federico Luongo, Giovanna Manzi, Gianmarco Scoccia, Cristiano Miotti, Robert Naeije, Susanna Sciomer, Francesco Fedele, Gavino Casu, Silvia Papa, Carmine Dario Vizza, Beatrice Pezzuto, Roberto Poscia |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry Diastole Idiopathic Pulmonary Arterial Hypertension Hemodynamics Strain (injury) Speckle tracking echocardiography 030204 cardiovascular system & hematology medicine.disease 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Right heart failure Internal medicine Rv function medicine Cardiology Radiology Nuclear Medicine and imaging Clinical significance Cardiology and Cardiovascular Medicine business clinical worsening pulmonary arterial hypertension right ventricular diastolic function right ventricular post-systolic strain speckle tracking echocardiography |
| Zdroj: | JACC: Cardiovascular Imaging. 14:162-172 |
| ISSN: | 1936-878X |
| DOI: | 10.1016/j.jcmg.2020.08.017 |
| Popis: | Objectives The purpose of this study was to explore speckle tracking echocardiographic right ventricular (RV) post-systolic strain patterns and their clinical relevance in idiopathic pulmonary arterial hypertension (PAH). Background The imaging of RV diastolic function in PAH remains incompletely understood. Methods Speckle tracking echocardiography of RV post-systolic strain recordings were examined in 108 consecutive idiopathic patients with PAH. Each of them underwent baseline clinical, hemodynamic, and complete echocardiographic evaluation and follow-up. Results In total, 3 post-systolic strain patterns derived from the mid-basal RV free wall segments were identified. Pattern 1 was characterized by prompt return of strain-time curves to baseline after peak systolic negativity, like in normal control subjects. Pattern 2 was characterized by persisting negativity of strain-time curves well into diastole, before an end-diastolic returning to baseline. Pattern 3 was characterized by a slow return of strain-time curves to baseline during diastole. The 3 patterns corresponded respectively to mild PH, more advanced PH but with still preserved RV function, and PH with obvious end-stage right heart failure. Patterns were characterized by optimal reproducibility when complementary to quantitative measurement of right ventricular longitudinal early diastolic strain rate (RVLSR-E), and right ventricular longitudinal late diastolic strain rate (RVLSR-A) (Cohen's κ = 0.88; p = 0.0001). Multivariable models for clinical worsening prediction demonstrated that the addition of RV post-systolic patterns to clinical and hemodynamic variables significantly increased their prognostic power (0.78 vs. 0.66; p Conclusions Speckle tracking echocardiography allows for the identification of 3 phenotypically distinct, reproducible, and clinically meaningful RV strain-derived post-systolic patterns. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|