A Comparative Study of Right Ventricular Strain to Established Echocardiographic Parameters in Pulmonary Hypertension

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Seaton, D
Yamada, A
Chan, J
Shearer, B
Aldridge, K
Kermeen, F
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2015
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Nice, France

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Purpose Right ventricular (RV) function is a strong predictor of morbidity and mortality in pulmonary hypertension (PH). The measurement of right ventricular global strain (RVGS) is a developing quantitative, non-invasive parameter in the assessment of the RV. The aim of this study was to compare global RV longitudinal strain (RVLS) relative to established echocardiographic indices in the assessment RV dysfunction in a cohort of PH patients with pseudo-normalised tricuspid annular plane systolic excursion (TAPSE) and S’ velocity.

Methods 52 consecutive patients (mean age 56±2.2, mean NYHA-FC 3.2, 25 IPAH, 13 PAH-CVD, 3 PAH-CHD, 5 CTEPH, 5 out of proportion PHT & 1 Porto-pulmonary-PH) underwent 2D transthoracic speckle tracking echocardiography with modified apical 4 chamber view focused on RV. Global RVLS was measured offline using EchoPAC BT011 GE software. Global RVLS was compared to established RV echocardiographic parameters using Pearson’s correlation.

Results Global RVLS demonstrated modest correlation with RV dysfunction by visual estimation (r=0.458, p=0.001; r=0.512,p=0.001) and NYHA functional class (r=0.487,p<0.001; r=.0481,p<0.001) compared with other parameters of RV function, including TAPSE ( r=0.017; p=0.916), RV S’ tissue Doppler (r=-0.273; p=0.069 ), PAEDP (r=0.063; p=0.71 ) and fractional area change (r=-0.337; p = 0.025).

Conclusion Our study failed to show correlation of global RVLS to established echocardiographic parameters of RV dysfunction in a cohort of patients with severe PH. However, RVGS is a developing quantitative, non-invasive parameter that requires more study to define the relationship of RVGS to mortality and morbidity in PH.

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Journal of Heart and Lung Transplantation

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34

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4

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Cardiovascular medicine and haematology

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Life Sciences & Biomedicine

Cardiac & Cardiovascular Systems

Respiratory System

Surgery

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Seaton, D; Yamada, A; Chan, J; Shearer, B; Aldridge, K; Kermeen, F, A Comparative Study of Right Ventricular Strain to Established Echocardiographic Parameters in Pulmonary Hypertension, Journal of Heart and Lung Transplantation, 2015, 34 (4), pp. S343-S343