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Comprehensive assessment of right ventricular function in patients with pulmonary hypertension with global longitudinal peak systolic strain derived from multiple right ventricular views.
J Am Soc Echocardiogr. 2014 Jun; 27(6):657-665.e3.JA

Abstract

BACKGROUND

Right ventricular (RV) function is a strong predictor of mortality in pulmonary hypertension (PH), but two-dimensional (2D) echocardiography-derived assessments of RV function that could aid in risk assessment and management of patients with PH are of limited utility. RV longitudinal peak systolic strain (RVLS) derived from 2D speckle-tracking echocardiography is a relatively novel method for quantifying RV function but typically is derived from a single apical four-chamber view of the right ventricle and may have inherent limitations. The objective of this study was to determine the utility of regional and global RVLS calculated from multiple views of the right ventricle to comprehensively assess RV function in a cohort of patients with PH.

METHODS

Regional and global RVLS were obtained from multiple views of the right ventricle (centered on the right ventricle-focused apical position) in 40 patients with PH, defined as a mean pulmonary artery pressure ≥ 25 mm Hg, most of whom also had pulmonary capillary wedge pressures ≤ 15 mm Hg and were thus defined as having pulmonary arterial hypertension. This was compared with other 2D echocardiography-derived parameters of RV function and functional parameters.

RESULTS

Global RVLS calculated from multiple views had a superior correlation with 6-min walk distance compared with other parameters of RV function, including tricuspid annular plane systolic excursion, RV myocardial performance index, and fractional area change. Although global RVLS calculated from multiple views displayed a similar correlation with 6-min walk distance as global RVLS calculated from a single four-chamber view, analysis of regional strains provided by multiple views identified distinct patterns of RV dysfunction, consisting of global, free wall, or septal dysfunction, that were associated with specific clinical characteristics.

CONCLUSIONS

Global RVLS derived from multiple right ventricle-focused views yields a comprehensive quantitative assessment of regional and global RV function that correlates moderately with functional parameters and may be useful in the assessment of PH. Distinct patterns of regional RV dysfunction are associated with different clinical characteristics.

Authors+Show Affiliations

Department of Medicine, Duke University Medical Center, Durham, North Carolina. Electronic address: sudarshan.rajagopal@dm.duke.edu.Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.Department of Cardiology, Hvidovre Hospital, Hvidovre, Denmark; Beverly Hills, California.Department of Pediatrics, Duke University Medical Center, Durham, North Carolina.Department of Medicine, Duke University Medical Center, Durham, North Carolina.Department of Medicine, Duke University Medical Center, Durham, North Carolina.Department of Medicine, Cedars-Sinai Medical Center, Beverly Hills, California (V.F.T.).Department of Medicine, Duke University Medical Center, Durham, North Carolina.Department of Medicine, Duke University Medical Center, Durham, North Carolina.Department of Medicine, Duke University Medical Center, Durham, North Carolina.

Pub Type(s)

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

Language

eng

PubMed ID

24656881

Citation

Rajagopal, Sudarshan, et al. "Comprehensive Assessment of Right Ventricular Function in Patients With Pulmonary Hypertension With Global Longitudinal Peak Systolic Strain Derived From Multiple Right Ventricular Views." Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, vol. 27, no. 6, 2014, pp. 657-665.e3.
Rajagopal S, Forsha DE, Risum N, et al. Comprehensive assessment of right ventricular function in patients with pulmonary hypertension with global longitudinal peak systolic strain derived from multiple right ventricular views. J Am Soc Echocardiogr. 2014;27(6):657-665.e3.
Rajagopal, S., Forsha, D. E., Risum, N., Hornik, C. P., Poms, A. D., Fortin, T. A., Tapson, V. F., Velazquez, E. J., Kisslo, J., & Samad, Z. (2014). Comprehensive assessment of right ventricular function in patients with pulmonary hypertension with global longitudinal peak systolic strain derived from multiple right ventricular views. Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, 27(6), 657-e3. https://doi.org/10.1016/j.echo.2014.02.001
Rajagopal S, et al. Comprehensive Assessment of Right Ventricular Function in Patients With Pulmonary Hypertension With Global Longitudinal Peak Systolic Strain Derived From Multiple Right Ventricular Views. J Am Soc Echocardiogr. 2014;27(6):657-665.e3. PubMed PMID: 24656881.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comprehensive assessment of right ventricular function in patients with pulmonary hypertension with global longitudinal peak systolic strain derived from multiple right ventricular views. AU - Rajagopal,Sudarshan, AU - Forsha,Daniel E, AU - Risum,Niels, AU - Hornik,Christoph P, AU - Poms,Abby D, AU - Fortin,Terry A, AU - Tapson,Victor F, AU - Velazquez,Eric J, AU - Kisslo,Joseph, AU - Samad,Zainab, Y1 - 2014/03/20/ PY - 2013/09/27/received PY - 2014/3/25/entrez PY - 2014/3/25/pubmed PY - 2015/1/13/medline KW - 6-minute walk distance KW - Pulmonary hypertension KW - Right ventricular function KW - Speckle-tracking echocardiography KW - Strain SP - 657 EP - 665.e3 JF - Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography JO - J Am Soc Echocardiogr VL - 27 IS - 6 N2 - BACKGROUND: Right ventricular (RV) function is a strong predictor of mortality in pulmonary hypertension (PH), but two-dimensional (2D) echocardiography-derived assessments of RV function that could aid in risk assessment and management of patients with PH are of limited utility. RV longitudinal peak systolic strain (RVLS) derived from 2D speckle-tracking echocardiography is a relatively novel method for quantifying RV function but typically is derived from a single apical four-chamber view of the right ventricle and may have inherent limitations. The objective of this study was to determine the utility of regional and global RVLS calculated from multiple views of the right ventricle to comprehensively assess RV function in a cohort of patients with PH. METHODS: Regional and global RVLS were obtained from multiple views of the right ventricle (centered on the right ventricle-focused apical position) in 40 patients with PH, defined as a mean pulmonary artery pressure ≥ 25 mm Hg, most of whom also had pulmonary capillary wedge pressures ≤ 15 mm Hg and were thus defined as having pulmonary arterial hypertension. This was compared with other 2D echocardiography-derived parameters of RV function and functional parameters. RESULTS: Global RVLS calculated from multiple views had a superior correlation with 6-min walk distance compared with other parameters of RV function, including tricuspid annular plane systolic excursion, RV myocardial performance index, and fractional area change. Although global RVLS calculated from multiple views displayed a similar correlation with 6-min walk distance as global RVLS calculated from a single four-chamber view, analysis of regional strains provided by multiple views identified distinct patterns of RV dysfunction, consisting of global, free wall, or septal dysfunction, that were associated with specific clinical characteristics. CONCLUSIONS: Global RVLS derived from multiple right ventricle-focused views yields a comprehensive quantitative assessment of regional and global RV function that correlates moderately with functional parameters and may be useful in the assessment of PH. Distinct patterns of regional RV dysfunction are associated with different clinical characteristics. SN - 1097-6795 UR - https://www.unboundmedicine.com/medline/citation/24656881/Comprehensive_assessment_of_right_ventricular_function_in_patients_with_pulmonary_hypertension_with_global_longitudinal_peak_systolic_strain_derived_from_multiple_right_ventricular_views_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0894-7317(14)00107-2 DB - PRIME DP - Unbound Medicine ER -