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Tricuspid regurgitation duration correlates with cardiovascular magnetic resonance-derived right ventricular ejection fraction and predict prognosis in patients with pulmonary arterial hypertension.
Eur Heart J Cardiovasc Imaging. 2014 Jan; 15(1):18-23.EH

Abstract

AIMS

Right ventricular (RV) failure is known to be the main cause of mortality and is closely related to prognosis in patients with pulmonary arterial hypertension (PAH). A decrease in the duration of tricuspid regurgitation corrected for heart rate (TRDc) has recently been shown to be associated with advanced RV failure and poor clinical outcomes. The aim of the present study was to investigate whether TRDc correlates with RV parameters assessed using cardiovascular magnetic resonance (CMR) and has prognostic significance in patients with PAH.

METHODS AND RESULTS

Thirty-seven consecutive patients with PAH (28 females, age 46 ± 14 years) underwent a 6 min walk test, right heart catheterization, echocardiography, and CMR within a 48 h period. Tricuspid regurgitation duration corrected for heart rate, tricuspid annular plane systolic excursion (TAPSE), Tei index, and tricuspid valve lateral annular systolic velocity were measured on echocardiography, and RV end-systolic and end-diastolic volumes and ejection fraction were measured on CMR. Tricuspid regurgitation duration corrected for heart rate was positively correlated with RV ejection fraction as measured on CMR (r = 0.400, P = 0.014). On multivariate regression analysis, TRDc was also significantly correlated with RV ejection fraction even after adjusting for the eccentric index, Tei index, and TAPSE (P = 0.034). During a median follow-up period of 487 days, there were seven events (19%) including two cardiac deaths and five inpatient admissions for heart failure. The event-free survival rate was significantly higher for patients with TRDc >400 ms than those with TRDc ≤400 ms (P = 0.040).

CONCLUSION

Tricuspid regurgitation duration corrected for heart rate correlated with CMR-derived RV ejection fraction, and decreased TRDc was associated with cardiovascular mortality and rehospitalization in patients with PAH. Therefore, TRDc could be a useful echocardiographic surrogate marker for predicting RV dysfunction and prognosis in patients with PAH.

Authors+Show Affiliations

Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, 250 Seungsanno, Seodaemun-gu, Seoul 120-752, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23704751

Citation

Cho, In-Jeong, et al. "Tricuspid Regurgitation Duration Correlates With Cardiovascular Magnetic Resonance-derived Right Ventricular Ejection Fraction and Predict Prognosis in Patients With Pulmonary Arterial Hypertension." European Heart Journal Cardiovascular Imaging, vol. 15, no. 1, 2014, pp. 18-23.
Cho IJ, Oh J, Chang HJ, et al. Tricuspid regurgitation duration correlates with cardiovascular magnetic resonance-derived right ventricular ejection fraction and predict prognosis in patients with pulmonary arterial hypertension. Eur Heart J Cardiovasc Imaging. 2014;15(1):18-23.
Cho, I. J., Oh, J., Chang, H. J., Park, J., Kang, K. W., Kim, Y. J., Choi, B. W., Shin, S., Shim, C. Y., Hong, G. R., Ha, J. W., & Chung, N. (2014). Tricuspid regurgitation duration correlates with cardiovascular magnetic resonance-derived right ventricular ejection fraction and predict prognosis in patients with pulmonary arterial hypertension. European Heart Journal Cardiovascular Imaging, 15(1), 18-23. https://doi.org/10.1093/ehjci/jet094
Cho IJ, et al. Tricuspid Regurgitation Duration Correlates With Cardiovascular Magnetic Resonance-derived Right Ventricular Ejection Fraction and Predict Prognosis in Patients With Pulmonary Arterial Hypertension. Eur Heart J Cardiovasc Imaging. 2014;15(1):18-23. PubMed PMID: 23704751.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tricuspid regurgitation duration correlates with cardiovascular magnetic resonance-derived right ventricular ejection fraction and predict prognosis in patients with pulmonary arterial hypertension. AU - Cho,In-Jeong, AU - Oh,Jaewon, AU - Chang,Hyuk-Jae, AU - Park,Junbeom, AU - Kang,Ki-Woon, AU - Kim,Young-Jin, AU - Choi,Byoung-Wook, AU - Shin,Sanghoon, AU - Shim,Chi Young, AU - Hong,Geu-Ru, AU - Ha,Jong-Won, AU - Chung,Namsik, Y1 - 2013/05/22/ PY - 2013/5/25/entrez PY - 2013/5/25/pubmed PY - 2014/9/6/medline KW - Prognosis KW - Pulmonary arterial hypertension KW - Right ventricular function SP - 18 EP - 23 JF - European heart journal cardiovascular Imaging JO - Eur Heart J Cardiovasc Imaging VL - 15 IS - 1 N2 - AIMS: Right ventricular (RV) failure is known to be the main cause of mortality and is closely related to prognosis in patients with pulmonary arterial hypertension (PAH). A decrease in the duration of tricuspid regurgitation corrected for heart rate (TRDc) has recently been shown to be associated with advanced RV failure and poor clinical outcomes. The aim of the present study was to investigate whether TRDc correlates with RV parameters assessed using cardiovascular magnetic resonance (CMR) and has prognostic significance in patients with PAH. METHODS AND RESULTS: Thirty-seven consecutive patients with PAH (28 females, age 46 ± 14 years) underwent a 6 min walk test, right heart catheterization, echocardiography, and CMR within a 48 h period. Tricuspid regurgitation duration corrected for heart rate, tricuspid annular plane systolic excursion (TAPSE), Tei index, and tricuspid valve lateral annular systolic velocity were measured on echocardiography, and RV end-systolic and end-diastolic volumes and ejection fraction were measured on CMR. Tricuspid regurgitation duration corrected for heart rate was positively correlated with RV ejection fraction as measured on CMR (r = 0.400, P = 0.014). On multivariate regression analysis, TRDc was also significantly correlated with RV ejection fraction even after adjusting for the eccentric index, Tei index, and TAPSE (P = 0.034). During a median follow-up period of 487 days, there were seven events (19%) including two cardiac deaths and five inpatient admissions for heart failure. The event-free survival rate was significantly higher for patients with TRDc >400 ms than those with TRDc ≤400 ms (P = 0.040). CONCLUSION: Tricuspid regurgitation duration corrected for heart rate correlated with CMR-derived RV ejection fraction, and decreased TRDc was associated with cardiovascular mortality and rehospitalization in patients with PAH. Therefore, TRDc could be a useful echocardiographic surrogate marker for predicting RV dysfunction and prognosis in patients with PAH. SN - 2047-2412 UR - https://www.unboundmedicine.com/medline/citation/23704751/Tricuspid_regurgitation_duration_correlates_with_cardiovascular_magnetic_resonance_derived_right_ventricular_ejection_fraction_and_predict_prognosis_in_patients_with_pulmonary_arterial_hypertension_ L2 - https://academic.oup.com/ehjcimaging/article-lookup/doi/10.1093/ehjci/jet094 DB - PRIME DP - Unbound Medicine ER -