Right Heart Chambers Longitudinal Strain Provides Enhanced Diagnosis and Categorization in Patients With Pulmonary Hypertension.
echocardiography
pulmonary hypertension
right atrial global longitudinal strain
right ventricular free wall longitudinal strain
systolic pulmonary arterial pressure
Journal
Frontiers in cardiovascular medicine
ISSN: 2297-055X
Titre abrégé: Front Cardiovasc Med
Pays: Switzerland
ID NLM: 101653388
Informations de publication
Date de publication:
2022
2022
Historique:
received:
22
12
2021
accepted:
14
02
2022
entrez:
18
4
2022
pubmed:
19
4
2022
medline:
19
4
2022
Statut:
epublish
Résumé
Increased systolic pulmonary arterial pressure (sPAP) could lead to the mechanical dysfunction and myocardial fibrosis of the right heart chambers. Echocardiographic strain analysis has not been adequately studied in patients with pulmonary hypertension (PH). A cross-sectional cohort of patients with suspected PH and echocardiographic strain evaluation was recruited. The cut-off values of peak tricuspid regurgitation velocity (TRV) with the low probability of PH (≤2.8 m/s), intermediate probability (2.9-3.4 m/s, without other echo PH signs), and high probability of PH (2.9-3.4 m/s with other echo PH signs and >3.4 m/s) categories were studied by right ventricular and right atrial (RA) strain analysis in a sample of 236 patients. The results showed that 58 (56.9%) patients had low, 15 (14.7%) had intermediate, and 29 (28.4%) had a high probability of PH. We observed a negative association between right ventricular free wall strain (RV-FWS) and atrial global strain with sPAP. With the increase in PH severity, RA reservoir, conduit, and contraction (booster) strain values decreased. The identified cut-off values of strain parameters had an adequate ability to detect PH severity categories. In addition, the post-mortem biopsies of right heart chambers from subjects with known severe PH were analyzed to quantify myocardial fibrosis. Our sample of right heart biopsies ( Mechanical dysfunction and fibrosis in the right chambers are associated with increased sPAP. Right ventricular and atrial strain could provide enhancement in the diagnosis and categorization of subjects with suspected PH.
Sections du résumé
Background
UNASSIGNED
Increased systolic pulmonary arterial pressure (sPAP) could lead to the mechanical dysfunction and myocardial fibrosis of the right heart chambers. Echocardiographic strain analysis has not been adequately studied in patients with pulmonary hypertension (PH).
Study design and methods
UNASSIGNED
A cross-sectional cohort of patients with suspected PH and echocardiographic strain evaluation was recruited. The cut-off values of peak tricuspid regurgitation velocity (TRV) with the low probability of PH (≤2.8 m/s), intermediate probability (2.9-3.4 m/s, without other echo PH signs), and high probability of PH (2.9-3.4 m/s with other echo PH signs and >3.4 m/s) categories were studied by right ventricular and right atrial (RA) strain analysis in a sample of 236 patients.
Results
UNASSIGNED
The results showed that 58 (56.9%) patients had low, 15 (14.7%) had intermediate, and 29 (28.4%) had a high probability of PH. We observed a negative association between right ventricular free wall strain (RV-FWS) and atrial global strain with sPAP. With the increase in PH severity, RA reservoir, conduit, and contraction (booster) strain values decreased. The identified cut-off values of strain parameters had an adequate ability to detect PH severity categories. In addition, the post-mortem biopsies of right heart chambers from subjects with known severe PH were analyzed to quantify myocardial fibrosis. Our sample of right heart biopsies (
Conclusion
UNASSIGNED
Mechanical dysfunction and fibrosis in the right chambers are associated with increased sPAP. Right ventricular and atrial strain could provide enhancement in the diagnosis and categorization of subjects with suspected PH.
Identifiants
pubmed: 35433867
doi: 10.3389/fcvm.2022.841776
pmc: PMC9008240
doi:
Types de publication
Journal Article
Langues
eng
Pagination
841776Informations de copyright
Copyright © 2022 Espinola-Zavaleta, Antonio-Villa, Guerra, Nanda, Rudski, Alvarez-Santana, Camacho-Camacho, Aranda-Fraustro, Cossio-Aranda, Zamora, Oregel-Camacho, Armenta-Moreno, Berarducci and Alexanderson-Rosas.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Cardiovasc Ultrasound. 2020 May 14;18(1):13
pubmed: 32410698
Circ Cardiovasc Imaging. 2018 Oct;11(10):e007249
pubmed: 30354477
Eur Heart J Cardiovasc Imaging. 2019 Apr 1;20(4):475-484
pubmed: 30169841
Can J Cardiol. 2018 Aug;34(8):1069-1078
pubmed: 30056845
Diseases. 2018 May 16;6(2):
pubmed: 29772649
Heart Lung Circ. 2019 Sep;28(9):1339-1350
pubmed: 31175016
J Am Soc Echocardiogr. 2021 Aug;34(8):851-861.e1
pubmed: 33774108
Eur Respir J. 2017 Nov 22;50(5):
pubmed: 29167303
Echo Res Pract. 2020 Feb 27;7(1):G19-G41
pubmed: 32105053
Circ Cardiovasc Imaging. 2013 Sep;6(5):609-11
pubmed: 24046376
Am J Cardiol. 2001 Nov 1;88(9):1060-3
pubmed: 11704014
J Am Soc Echocardiogr. 2015 Jan;28(1):1-39.e14
pubmed: 25559473
Can Respir J. 2017;2017:1430350
pubmed: 28286407
J Cardiovasc Imaging. 2018 Sep;26(3):111-124
pubmed: 30310878
Medicina (Kaunas). 2019 Mar 20;55(3):
pubmed: 30897834
Cardiovasc Ultrasound. 2020 Jan 27;18(1):4
pubmed: 31987049
J Am Coll Cardiol. 2014 Jul 1;63(25 Pt A):2751-68
pubmed: 24703918
J Cardiovasc Echogr. 2015 Jan-Mar;25(1):1-8
pubmed: 28465921
J Am Soc Echocardiogr. 2011 Mar;24(3):277-313
pubmed: 21338865
PLoS One. 2019 Dec 2;14(12):e0225829
pubmed: 31790492
Rev Esp Cardiol (Engl Ed). 2016 Feb;69(2):177
pubmed: 26837729
Eur Respir Rev. 2010 Dec;19(118):288-99
pubmed: 21119187
J Am Soc Echocardiogr. 2010 Jul;23(7):685-713; quiz 786-8
pubmed: 20620859
Circ Cardiovasc Imaging. 2013 Sep;6(5):711-21
pubmed: 23811750