Accuracy of Echocardiography to Evaluate Pulmonary Vascular and RV Function During Exercise

Abstract

Echocardiographic estimates of RV and pulmonary vascular function are feasible during exercise and identify pathology with reasonable accuracy. They represent valid screening tools for the identification of pulmonary vascular disease in routine clinical practice.

Improving the physiological realism of experimental models

“…Cardiac outputs determined using this technique correlate very strongly with invasive Fick measures but the reproducibility is arguably better with Ex-CMR [90]. Furthermore, although echo-cardiographic images cannot be acquired in all subjects, the accuracy of measures that can be obtained are reasonably impressive [91]. Thus, we can now move away from the limitations of pharmacological surrogates and more directly assess cardiac function during exercise in humans.…”

Exercise Doppler echocardiography for the diagnosis of pulmonary hypertension: renewed interest and evolving roles

“…In the study by Kovacs et al, there was no significant difference in SPAP between exercise Doppler echocardiography and right heart catheterisation at increasing stages of semi-supine bicycle exercise (13). In a more recent study by Claessen et al, both MPAP and SPAP from echocardiography had good correlations with exercise cardiac magnetic resonance imaging combined with simultaneous invasive pressure registration (12). The echocardiographic-derived MPAP/CO was obtained in 87% of the study subjects.…”

“…Indeed, in selected instances, the quality of Doppler echocardiographic signals can be improved by the administration of contrast or the use of dedicated imaging protocol. The use of agitated colloid enhancement has been shown to improve the detection of TR, which was not apparent or absent on non-contrasted study (12). Although there is an inherent risk of pressure overestimation from 'spike' noise artefact, it is by and large a useful tool and should be considered when the Doppler signal is of suboptimal quality.…”

Current issues in evaluation of the right ventricle condition: Role of gender and ethnic features and exercise

“…Вероятно, по этой же причине прак-тически не проводится ЭхоКГ контроль эффективно-сти физических тренировок у этой категории больных. Нагрузочные исследования функции ПЖ у больных с легочной гипертензией проводятся на данном этапе в основном при помощи кардиологической магнитно-резонансной томографии [38,39,50], что не позволяет использовать ее в рутинной практике ввиду ограничен-ной доступности и дороговизны. Может быть, поэто-му исследования с применением ЭхоКГ у этих больных все-таки проводятся.…”

“…Однако в другом исследовании у пациентов с легочной гипертензией на фоне ТЭЛА была убедительно показана высокая чувствительность ЭхоКГ в сравнении с нагрузочной МРТ. В данной работе получены выраженные корреляционные связи показателей систолической функции ПЖ, полученных при стресс-ЭхоКГ (FAC, TAPSE), и ФВ ПЖ при нагру-зочной МРТ [50].…”