Echocardiographic Evaluation of Right Ventricular Stroke Work Index in Advanced Heart Failure: A New Index?

Frea, Simone; Bovolo, Virginia; Bergerone, Serena; D’Ascenzo, Fabrizio; Antolini, M.; Capriolo, Michele; Canavosio, Federico Giovanni; Morello, Mara; Gaïta, Fiorenzo

doi:10.1016/j.cardfail.2012.10.018

Cited by 43 publications

(36 citation statements)

References 23 publications

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“…6 To date, several studies have examined various predictors of RVF after LVAD implantation, including serum, echocardiographic, and invasive hemodynamic markers. [7][8][9][10][11][12][13][14] Unfortunately, accurately predicting the RV response to LVAD implantation, given the lack of consensus among these studies, remains a challenge. Furthermore, few studies have examined ways to identify patients who will require RVAD support.…”

mentioning

confidence: 99%

Pulmonary artery pulsatility index predicts right ventricular failure after left ventricular assist device implantation

Kang

Banerjee

2016

The Journal of Heart and Lung Transplantation

217

130

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mentioning

confidence: 99%

Pulmonary artery pulsatility index predicts right ventricular failure after left ventricular assist device implantation

Kang

Banerjee

2016

The Journal of Heart and Lung Transplantation

217

130

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“…Many sonographic studies have focused in cardiac applications; the kidney function assessments were often derived from measurements of cardiac status rather than a direct study of kidney [20][21][22][23][24][25] . We have established an imaging methodology to visualize anatomical and functional changes in kidney in real time.…”

Section: Discussionmentioning

confidence: 99%

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Fisch

Liao

Hsiao

et al. 2016

JoVE

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The kidney normally functions to maintain hemodynamic homeostasis and is a major site of damage caused by drug toxicity. Drug-induced nephrotoxicity is estimated to contribute to 19-25% of all clinical cases of acute kidney injury (AKI) in critically ill patients. AKI detection has historically relied on metrics such as serum creatinine (sCr) or blood urea nitrogen (BUN) which are demonstrably inadequate in full assessment of nephrotoxicity in the early phase of renal dysfunction. Currently, there is no robust diagnostic method to accurately detect hemodynamic alteration in the early phase of AKI while such alterations might actually precede the rise in serum biomarker levels. Such early detection can help clinicians make an accurate diagnosis and help in in decision making for therapeutic strategy. Rats were treated with Cisplatin to induce AKI. Nephrotoxicity was assessed for six days using high-frequency sonography, sCr measurement and upon histopathology of kidney. Hemodynamic evaluation using 2D and Color-Doppler images were used to serially study nephrotoxicity in rats, using the sonography. Our data showed successful drug-induced kidney injury in adult rats by histological examination. Color-Doppler based sonographic assessment of AKI indicated that resistive-index (RI) and pulsatile-index (PI) were increased in the treatment group; and peak-systolic velocity (mm/s), end-diastolic velocity (mm/s) and velocity-time integral (VTI, mm) were decreased in renal arteries in the same group. Importantly, these hemodynamic changes evaluated by sonography preceded the rise of sCr levels. Sonography-based indices such as RI or PI can thus be useful predictive markers of declining renal function in rodents. From our sonography-based observations in the kidneys of rats that underwent AKI, we showed that these noninvasive hemodynamic measurements may consider as an accurate, sensitive and robust method in detecting early stage kidney dysfunction. This study also underscores the importance of ethical issues associated with animal use in research.

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“…Prior reports have described a variety of techniques for performing right heart measurements 3,4,11,[17][18][19] . However, the majority of previous studies reported RV size and structural data in a predominantly qualitative rather than quantitative fashion 5 .…”

Section: Discussionmentioning

confidence: 99%

Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography

Cheng

Fisch

Cheng

et al. 2014

JoVE

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Emerging clinical data support the notion that RV dysfunction is critical to the pathogenesis of cardiovascular disease and heart failure [1][2][3] . Moreover, the RV is significantly affected in pulmonary diseases such as pulmonary artery hypertension (PAH). In addition, the RV is remarkably sensitive to cardiac pathologies, including left ventricular (LV) dysfunction, valvular disease or RV infarction 4 . To understand the role of RV in the pathogenesis of cardiac diseases, a reliable and noninvasive method to access the RV structurally and functionally is essential.A noninvasive trans-thoracic echocardiography (TTE) based methodology was established and validated for monitoring dynamic changes in RV structure and function in adult mice. To impose RV stress, we employed a surgical model of pulmonary artery constriction (PAC) and measured the RV response over a 7-day period using a high-frequency ultrasound microimaging system. Sham operated mice were used as controls. Images were acquired in lightly anesthetized mice at baseline (before surgery), day 0 (immediately post-surgery), day 3, and day 7 (post-surgery). Data was analyzed offline using software.Several acoustic windows (B, M, and Color Doppler modes), which can be consistently obtained in mice, allowed for reliable and reproducible measurement of RV structure (including RV wall thickness, end-diastolic and end-systolic dimensions), and function (fractional area change, fractional shortening, PA peak velocity, and peak pressure gradient) in normal mice and following PAC.Using this method, the pressure-gradient resulting from PAC was accurately measured in real-time using Color Doppler mode and was comparable to direct pressure measurements performed with a Millar high-fidelity microtip catheter. Taken together, these data demonstrate that RV measurements obtained from various complimentary views using echocardiography are reliable, reproducible and can provide insights regarding RV structure and function. This method will enable a better understanding of the role of RV cardiac dysfunction. Video LinkThe video component of this article can be found at

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Echocardiographic Evaluation of Right Ventricular Stroke Work Index in Advanced Heart Failure: A New Index?

Cited by 43 publications

References 23 publications

Pulmonary artery pulsatility index predicts right ventricular failure after left ventricular assist device implantation

Pulmonary artery pulsatility index predicts right ventricular failure after left ventricular assist device implantation

Early Detection of Drug-Induced Renal Hemodynamic Dysfunction Using Sonographic Technology in Rats

Assessment of Right Ventricular Structure and Function in Mouse Model of Pulmonary Artery Constriction by Transthoracic Echocardiography

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