Prognostic role of pulmonary impedance estimation to predict right ventricular dysfunction in pulmonary hypertension.

Female Humans Male Hypertension, Pulmonary / complications Prognosis Ventricular Dysfunction, Right / diagnosis Prospective Studies Electric Impedance
Cardiac magnetic resonance imaging Pulmonary arterial impedance Right heart catheterization Right ventricular-pulmonary arterial coupling

Journal

ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191

Informations de publication

Date de publication:
06 2023
Historique:
revised: 30 08 2022
received: 07 07 2022
accepted: 15 09 2022
medline: 19 5 2023
pubmed: 11 3 2023
entrez: 10 3 2023
Statut: ppublish

Résumé

The effect of pulmonary hypertension (PH) on right ventricular (RV) afterload is commonly defined by elevation of pulmonary artery (PA) pressure or pulmonary vascular resistance (PVR). In humans however, one-third to half of the hydraulic power in the PA is contained in pulsatile components of flow. Pulmonary impedance (Zc) expresses opposition of the PA to pulsatile blood flow. We evaluate pulmonary Zc relationships according to PH classification using a cardiac magnetic resonance (CMR)/right heart catheterization (RHC) method. Prospective study of 70 clinically indicated patients referred for same-day CMR and RHC [60 ± 16 years; 77% females, 16 mPAP <25 mmHg (PVR <240 dynes.s.cm Baseline demographic characteristics were well matched. There was a significant difference in mPAP (P < 0.001), PVR (P = 0.001), and pulmonary Zc between mPAP<25 mmHg patients and those with PH (mPAP <25 mmHg: 47 ± 19 dynes.s.cm Raised pulmonary Zc was independent of elevated mPAP in patients with PH and more strongly predictive of maladaptive RV remodelling than PVR and mPAP. Use of this straightforward method to determine pulmonary Zc may help to better characterize pulsatile components of RV afterload in patients with PH than mPAP or PVR alone.

Sections du résumé

BACKGROUND
The effect of pulmonary hypertension (PH) on right ventricular (RV) afterload is commonly defined by elevation of pulmonary artery (PA) pressure or pulmonary vascular resistance (PVR). In humans however, one-third to half of the hydraulic power in the PA is contained in pulsatile components of flow. Pulmonary impedance (Zc) expresses opposition of the PA to pulsatile blood flow. We evaluate pulmonary Zc relationships according to PH classification using a cardiac magnetic resonance (CMR)/right heart catheterization (RHC) method.
METHODS
Prospective study of 70 clinically indicated patients referred for same-day CMR and RHC [60 ± 16 years; 77% females, 16 mPAP <25 mmHg (PVR <240 dynes.s.cm
RESULTS
Baseline demographic characteristics were well matched. There was a significant difference in mPAP (P < 0.001), PVR (P = 0.001), and pulmonary Zc between mPAP<25 mmHg patients and those with PH (mPAP <25 mmHg: 47 ± 19 dynes.s.cm
CONCLUSIONS
Raised pulmonary Zc was independent of elevated mPAP in patients with PH and more strongly predictive of maladaptive RV remodelling than PVR and mPAP. Use of this straightforward method to determine pulmonary Zc may help to better characterize pulsatile components of RV afterload in patients with PH than mPAP or PVR alone.

Identifiants

DOI: 10.1002/ehf2.14180 PMID: 36896830 PMC: PMC10192280
pubmed: 36896830
doi: 10.1002/ehf2.14180
pmc: PMC10192280
doi:

Types de publication

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

Langues

eng

Sous-ensembles de citation

IM

Pagination

1811-1821

Informations de copyright

© 2022 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

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Auteurs

Sara Louise Hungerford (SL)

Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia.
The University of New South Wales, Sydney, Australia.
Victor Chang Cardiac Research Institute, Sydney, Australia.
Department of Cardiology, Royal North Shore Hospital, Sydney, Australia.
ORCID: 0000-0003-0040-7719

Katherine Kearney (K)

Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia.
The University of New South Wales, Sydney, Australia.
Victor Chang Cardiac Research Institute, Sydney, Australia.

Ning Song (N)

Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia.
The University of New South Wales, Sydney, Australia.
Victor Chang Cardiac Research Institute, Sydney, Australia.

Nicole Bart (N)

Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia.
The University of New South Wales, Sydney, Australia.
Victor Chang Cardiac Research Institute, Sydney, Australia.

Eugene Kotlyar (E)

Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia.

Edmund Lau (E)

Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, Australia.

Andrew Jabbour (A)

Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia.
The University of New South Wales, Sydney, Australia.
Victor Chang Cardiac Research Institute, Sydney, Australia.

Christopher Simon Hayward (CS)

Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia.
The University of New South Wales, Sydney, Australia.
Victor Chang Cardiac Research Institute, Sydney, Australia.

David William Marshall Muller (DWM)

Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia.
The University of New South Wales, Sydney, Australia.
Victor Chang Cardiac Research Institute, Sydney, Australia.

Audrey Adji (A)

Department of Cardiology, St Vincent's Hospital, Darlinghurst, Australia.
The University of New South Wales, Sydney, Australia.
Victor Chang Cardiac Research Institute, Sydney, Australia.
BPVF department, Macquarie University Medical School, Sydney, Australia.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Prognostic role of pulmonary impedance...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Hypertension artérielle › Hypertension pulmonaire › Prognostic role of pulmonary impedance...
questionsmedicales.fr › Diagnostic › Pronostic › Prognostic role of pulmonary impedance...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Dysfonction ventriculaire › Dysfonction ventriculaire droite › Prognostic role of pulmonary impedance...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Prognostic role of pulmonary impedance...
questionsmedicales.fr › Phénomènes physiques › Phénomènes magnétiques › Phénomènes électromagnétiques › Électricité › Conductivité électrique › Impédance électrique › Prognostic role of pulmonary impedance...