Exploring Noninvasive Tricuspid dP/dt as a Marker of Right Ventricular Function

Autor:	Luan Tan Huynh, Sudhir Wahi, Yash Singbal, Arnold C.T. Ng, William Vollbon, William Y.S. Wang
Rok vydání:	2015
Předmět:	Male medicine.medical_specialty Heart Ventricles Ventricular Dysfunction Right Pressure Rate Sensitivity and Specificity Contractility Cardiac magnetic resonance imaging Internal medicine medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Retrospective Studies Observer Variation Ejection fraction medicine.diagnostic_test Ventricular function business.industry Reproducibility of Results Middle Aged Magnetic Resonance Imaging Echocardiography Doppler Tricuspid Valve Insufficiency Preload Rv function Ventricular Function Right cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business
Zdroj:	Echocardiography. 32:1347-1351
ISSN:	0742-2822
DOI:	10.1111/echo.12877
Popis:	Right ventricular (RV) function assumes prognostic significance in various disease states, but RV geometry is not amenable to volumetric assessment by two-dimensional echocardiography. Intra-ventricular pressure rate of rise (dP/dt) predicts myocardial contractility and adjusting for the maximal regurgitant velocity (Vmax) corrects for preload. We examined the relationship of noninvasive tricuspid dP/dt and dP/dt/Vmax with RV ejection fraction (RVEF) by cardiac magnetic resonance imaging (CMR) as a measure of RV function.Fifty CMRs and echocardiograms performed within 30 days were included. Tricuspid regurgitation (TR) spectral Doppler trace was analyzed offline. TR dP/dt was calculated using simplified Bernoulli equation (dP/dt between 1 and 2 m/sec). dP/dt/Vmax was calculated as a ratio of dP/dt and TR Vmax . RV end-diastolic (EDV) and end-systolic volumes (ESV) were obtained from contouring of steady-state-free precession axial stack CMR images; RVEF was calculated as [(RVEDV - RVESV)/RVEDV] × 100. RVEF42% was considered normal.Majority of studies were suitable for analysis. Median age was 48 years (IQR = 36-63); 56.4% were female (n = 22/39). There was correlation between dP/dt and RVEF (r(2) = 0.51, P0.01) which improved with dP/dt/Vmax (r(2) = 0.59, P0.01). dP/dt400 mmHg/sec had a positive predictive value of 91%, sensitivity and specificity of 74% and 84% respectively for normal RVEF. Inter-observer agreement and repeatability analysis showed no significant difference.Tricuspid dP/dt correlates well with CMR RVEF. A dP/dt of more than 400 mmHg/sec strongly predicts normal RVEF. Adjusting for preload (dP/dt/Vmax) further improves this correlation.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c27c3ad2b03d84f6d3977f80d558af29 https://doi.org/10.1111/echo.12877 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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