Right Ventricular Diastolic Performance in Patients With Chronic Thromboembolic Pulmonary Hypertension Assessed by Echocardiography

Background: There have been no systemic studies about right heart filling pressure and right ventricular (RV) distensibility in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Therefore, we aimed to explore combinations of echocardiographic indices to assess the stages of RV dia...

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Autores principales:	Hong Meng, Wu Song, Sheng Liu, David Hsi, Lin-Yuan Wan, Hui Li, Shan-shan Zheng, Zhi-wei Wang, Rong Ren, Wei-xian Yang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	chronic thromboembolic pulmonary artery hypertension right ventricular diastolic dysfunction early diastolic strain rate indexed right atrial area right heart filling pressure Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/d8be3881596e466e88243aee87c65394
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spelling	oai:doaj.org-article:d8be3881596e466e88243aee87c653942021-12-01T00:00:44ZRight Ventricular Diastolic Performance in Patients With Chronic Thromboembolic Pulmonary Hypertension Assessed by Echocardiography2297-055X10.3389/fcvm.2021.755251https://doaj.org/article/d8be3881596e466e88243aee87c653942021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.755251/fullhttps://doaj.org/toc/2297-055XBackground: There have been no systemic studies about right heart filling pressure and right ventricular (RV) distensibility in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Therefore, we aimed to explore combinations of echocardiographic indices to assess the stages of RV diastolic dysfunction.Methods and Results: We recruited 32 healthy volunteers and 71 patients with CTEPH. All participants underwent echocardiography, cardiac catheterization (in patients with CTEPH), and a 6-min walk test (6MWT). The right atrial (RA) end-systolic area was adjusted for body surface area (BSA) (indexed RA area). RV global longitudinal diastolic strain rates (SRs) and RV ejection fraction (EF) were measured by speckle tracking and three-dimensional echocardiography (3D echo), respectively. All 71 patients with CTEPH underwent pulmonary endarterectomy. Of the 71 patients, 52 (73%) had decreased RV systolic function; 12 (16.9%), 26 (36.6%), and 33 (46.5%) patients had normal RV diastolic pattern, abnormal relaxation (stage 1), and pseudo-normal patterns (stage 2), respectively. The receiver operating characteristic curve analysis showed that the optimal cut-off values of early diastolic SR <0.8 s−1 and indexed RA area > 8.8 cm2/BSA had the best accuracy in identifying patients with RV diastolic dysfunction, with 87% sensitivity and 82% specificity. During a mean follow-up of 25.2 months after pulmonary endarterectomy, the preoperative indexed RA area was shown as an independent risk factor of the decreased 6MWT distance.Conclusions: Measuring early diastolic SR and indexed RA area would be useful in stratifying RV diastolic function.Hong MengWu SongSheng LiuDavid HsiLin-Yuan WanHui LiShan-shan ZhengZhi-wei WangRong RenWei-xian YangFrontiers Media S.A.articlechronic thromboembolic pulmonary artery hypertensionright ventricular diastolic dysfunctionearly diastolic strain rateindexed right atrial arearight heart filling pressureDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	chronic thromboembolic pulmonary artery hypertension right ventricular diastolic dysfunction early diastolic strain rate indexed right atrial area right heart filling pressure Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	chronic thromboembolic pulmonary artery hypertension right ventricular diastolic dysfunction early diastolic strain rate indexed right atrial area right heart filling pressure Diseases of the circulatory (Cardiovascular) system RC666-701 Hong Meng Wu Song Sheng Liu David Hsi Lin-Yuan Wan Hui Li Shan-shan Zheng Zhi-wei Wang Rong Ren Wei-xian Yang Right Ventricular Diastolic Performance in Patients With Chronic Thromboembolic Pulmonary Hypertension Assessed by Echocardiography
description	Background: There have been no systemic studies about right heart filling pressure and right ventricular (RV) distensibility in patients with chronic thromboembolic pulmonary hypertension (CTEPH). Therefore, we aimed to explore combinations of echocardiographic indices to assess the stages of RV diastolic dysfunction.Methods and Results: We recruited 32 healthy volunteers and 71 patients with CTEPH. All participants underwent echocardiography, cardiac catheterization (in patients with CTEPH), and a 6-min walk test (6MWT). The right atrial (RA) end-systolic area was adjusted for body surface area (BSA) (indexed RA area). RV global longitudinal diastolic strain rates (SRs) and RV ejection fraction (EF) were measured by speckle tracking and three-dimensional echocardiography (3D echo), respectively. All 71 patients with CTEPH underwent pulmonary endarterectomy. Of the 71 patients, 52 (73%) had decreased RV systolic function; 12 (16.9%), 26 (36.6%), and 33 (46.5%) patients had normal RV diastolic pattern, abnormal relaxation (stage 1), and pseudo-normal patterns (stage 2), respectively. The receiver operating characteristic curve analysis showed that the optimal cut-off values of early diastolic SR <0.8 s−1 and indexed RA area > 8.8 cm2/BSA had the best accuracy in identifying patients with RV diastolic dysfunction, with 87% sensitivity and 82% specificity. During a mean follow-up of 25.2 months after pulmonary endarterectomy, the preoperative indexed RA area was shown as an independent risk factor of the decreased 6MWT distance.Conclusions: Measuring early diastolic SR and indexed RA area would be useful in stratifying RV diastolic function.
format	article
author	Hong Meng Wu Song Sheng Liu David Hsi Lin-Yuan Wan Hui Li Shan-shan Zheng Zhi-wei Wang Rong Ren Wei-xian Yang
author_facet	Hong Meng Wu Song Sheng Liu David Hsi Lin-Yuan Wan Hui Li Shan-shan Zheng Zhi-wei Wang Rong Ren Wei-xian Yang
author_sort	Hong Meng
title	Right Ventricular Diastolic Performance in Patients With Chronic Thromboembolic Pulmonary Hypertension Assessed by Echocardiography
title_short	Right Ventricular Diastolic Performance in Patients With Chronic Thromboembolic Pulmonary Hypertension Assessed by Echocardiography
title_full	Right Ventricular Diastolic Performance in Patients With Chronic Thromboembolic Pulmonary Hypertension Assessed by Echocardiography
title_fullStr	Right Ventricular Diastolic Performance in Patients With Chronic Thromboembolic Pulmonary Hypertension Assessed by Echocardiography
title_full_unstemmed	Right Ventricular Diastolic Performance in Patients With Chronic Thromboembolic Pulmonary Hypertension Assessed by Echocardiography
title_sort	right ventricular diastolic performance in patients with chronic thromboembolic pulmonary hypertension assessed by echocardiography
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/d8be3881596e466e88243aee87c65394
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Right Ventricular Diastolic Performance in Patients With Chronic Thromboembolic Pulmonary Hypertension Assessed by Echocardiography

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