Comprehensive Echocardiographic Assessment of the Right Ventricular Performance: beyond TAPSE and Fractional Area Change

Суркова, Елена; Kovács, Attila

doi:10.15829/1560-4071-2020-4067

Cited by 4 publications

(2 citation statements)

References 51 publications

(61 reference statements)

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“…The newest reviews highlighted the expediency of using recently developed imaging techniques, such as 3D echocardiography and speckle tracking analysis in diagnosing RV dysfunction. The combined results obtained via various echocardiographic methods allow obtaining a deeper understanding of the RV pathology, which, in our opinion, would lead to a more accurate diagnosis and better clinical management of patients with cardiovascular diseases in general [10], as well as during their anticancer therapy [14].…”

Section: Essential Facts About Studies Evaluating Rv Function Vs Cardiac Toxicity Diagnosingmentioning

confidence: 99%

“…However, an accurate evaluation of the RV condition via conventional echocardiography remains challenging due to intrinsic limitations of this imaging technique, along with complex geometry and contraction mechanisms of the RV. Recent developments in echocardiography expand the possibilities of using the RV parameter assessment in condition of various pathologies [10].…”

Section: Essential Facts About Studies Evaluating Rv Function Vs Cardiac Toxicity Diagnosingmentioning

confidence: 99%

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Evaluating Right Ventricular Function To Reveal Cancer Therapy Cardiotoxicity

Sumin

2021

Russ Open Med J

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Advances in cancer treatment resulted in augmented patient survival rate. However, anticancer therapy often causes heart damage in the form of a progressive systolic heart failure. Echocardiographic parameters of left ventricular function were conventionally used to detect early manifestations of cancer therapy cardiotoxicity. Improved diagnosing of the right ventricle condition revealed that it is negatively affected by chemotherapy as frequently as the left ventricle, and sometimes even earlier than the latter. Hence, currently, the right ventricle function and mechanics assessment techniques are actively developed for the chemotherapy cardiotoxicity diagnostic, primarily employing 3D echocardiography and speckle tracking analysis. The presented review provides relevant information on the matter and highlights insufficiently developed issues and fields of further research.

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Section: Essential Facts About Studies Evaluating Rv Function Vs Cardiac Toxicity Diagnosingmentioning

confidence: 99%

Section: Essential Facts About Studies Evaluating Rv Function Vs Cardiac Toxicity Diagnosingmentioning

confidence: 99%

Evaluating Right Ventricular Function To Reveal Cancer Therapy Cardiotoxicity

Sumin

2021

Russ Open Med J

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Prognostic Value of Right Ventricular Dysfunction in Patients With Decompensated Chronic Heart Failure

et al. 2023

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Aim To determine the incidence rate and the practical significance of right ventricular dysfunction (RVD) in the development of cardiovascular complications in patients with decompensated chronic heart failure (DCHF).Material and methods This prospective, single-site observational study included 171 patients older than 18 years with NYHA functional class (FC) II-IV chronic heart failure (CHF) who were hospitalized for DCHF. Standard and extended 2D and 3D echocardiography (EchoCG) was performed for all patients on admission. Additionally, functional characteristics of the right ventricle (RV) were evaluated in the 3D mode followed by autonomic 3D processing with a EchoPac station (USA). RVD was taken as a disorder of two or more RV functional parameters according to results of 2D EchoCG, or a reduced RV free wall strain according to results of 2D speckle-tracking EchoCG, or a reduced RV ejection fraction (EF) according to results of 3D EchoCG. Statistical analysis was performed with a SPSS Statistics v. 26.0 software.Results The incidence rate of RVD in general population of patients with DCHF was 75.4 % (n=129). A higher prevalence of RVD was observed in patients with CHF with a low left ventricular (LV) EF (90.1 %). Patients with RVD had a more severe clinical status (significantly higher FC and higher Clinical Condition Scale (CCS) scores), more frequent atrial fibrillation (AF), and higher concentrations of uric acid and total bilirubin. RVD significantly correlated with male sex (odds ratio (OR), 2.05; 95 % confidence interval (CI), 1.01–4.19; р=0.046) and AF (OR, 3.52; 95 % CI, 1.71–7.26; р<0.001). Patients with RVD had lower values of both LV and RV function. Lower LV EF and AF increased the probability of RVD by 1.06 times (95 % CI, 0.90–0.98; р=0.001) and by 2.63 times (95 % CI, 1.08–6.40; р=0.001), respectively. Evaluation of the predictive significance of RV parameters measured by 2D and 3D EchoCG showed only effects of RV EF (2D) and RV global longitudinal strain (GLS) (3D) on all-cause hospitalization. RVD as evaluated by accepted criteria did not influence adverse outcomes.Conclusion The determined incidence, correlations, and the predictive value of RVD in patients with DCHF indicated the appropriateness of assessing the RV function to optimize the management of patients regardless of the CHF phenotype.

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Analysis of the significance of echocardiographic signs of right ventricular dysfunction for predicting the outcome of heart failure with reduced left ventricular ejection fraction

Skidan,

Pavlyukova,

Nartsissova

et al. 2024

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Objective: to determine the ultrasound signs of right heart dysfunction, which increase the prognostic value of the recommended parameters of left ventricular (LV) dysfunction in patients with heart failure with reduced ejection fraction (HFrEF).Materials and methods. The prospective study included 79 patients with HFrEF LV with clinical manifestations of chronic heart failure functional class III according to the New York Heart Association (HF NYHA Class III) in 52 patients (65.8%) and HF NYHA Class IV in 27 (34.1%). The primary end point was death during a follow-up period of up to 3 years while waiting for heart transplantation.Results. Overall mortality was 33 patients (41.7%), 17 (21.5%) during the 1st year of follow-up. Regression analysis revealed the following independent ultrasound predictors of poor prognosis: LV ejection fraction on 3D-echocardiography (3DE LVEF), p = 0.014; global longitudinal strain of the LV (GLS LV), p = 0.010, and of the interventricular septum basal segment (IVSLS BS), p = 0.012; mean longitudinal strain of the basal segment of the right ventricle free wall (FWLS BS RV), p = 0.003. Changes in the configuration and dilatation of the LV cavity, an increase in LV end-diastolic pressure, impaired contractility, and strain of the LV myocardium can affect the function of the right ventricle (RV) through the common interventricular septum (IVS). Dilatation of the RV due to an increase in the end diastolic area (RV EDA) of more than 30 cm2 (p = 0.012) and end systolic area (RV ESA) of more than 25 cm2 (p = 0.001), an increase in the volume of the right atrium (3DE AKI) of more than 100 ml (p = 0.036), and a decrease in the % inspiratory collapse of the inferior vena cava (% IVC) less than 30% (p = 0.005) demonstrated a prognostic significance in the observed patients. A decrease in the deformation properties of the pancreas due to the longitudinal component and impaired strain of the basal segment makes a greater contribution to RV dysfunction (FWLS BS, % < -15% (p < 0.001)).Conclusions. RV dysfunction in patients with HFrEF is an unfavorable prognostic factor, independently associated with existing LV dysfunction. The most significant ultrasound sign for surveillance prediction of patients with LV HFrEF and RV dysfunction are indicators of ventricular myocardial deformation. Remodeling of the right chambers and dysfunction of the RV is a trigger for the separation of the RV and pulmonary artery, which ultimately leads to adverse outcomes.

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Comprehensive Echocardiographic Assessment of the Right Ventricular Performance: beyond TAPSE and Fractional Area Change

Cited by 4 publications

References 51 publications

Evaluating Right Ventricular Function To Reveal Cancer Therapy Cardiotoxicity

Evaluating Right Ventricular Function To Reveal Cancer Therapy Cardiotoxicity

Prognostic Value of Right Ventricular Dysfunction in Patients With Decompensated Chronic Heart Failure

Analysis of the significance of echocardiographic signs of right ventricular dysfunction for predicting the outcome of heart failure with reduced left ventricular ejection fraction

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