Echocardiographic Features of Primary Pulmonary Hypertension

Bossone, Eduardo; Duong-Wagner, Thanh H.; Paciocco, Giuseppe; Oral, Hakan; Ricciardi, Mark J.; Bach, David S.; Rubenfire, Melvyn; Armstrong, William F.

doi:10.1053/je.1999.v12.a99069

Cited by 114 publications

(80 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Conversely, LV systolic function, as measured by both standard 2D and TDI echocardiography, was preserved in the present IPF patients, another finding that is in keeping with previous reports evaluating LV systolic function in clinical entities that affect RV performance [4][5][6][7][8][9][10][11][12].…”

Section: Discussionsupporting

confidence: 91%

“…Right ventricular (RV) dysfunction has been well described in IPF patients, and in several conditions affecting pulmonary circulation, such as primary PH, chronic obstructive pulmonary disease, chronic thromboembolic PH, systemic sclerosis, systemic lupus erythematosus and cystic fibrosis [4][5][6][7][8][9][10]. Moreover, left ventricular (LV) diastolic dysfunction has been reported in some of these conditions [5-7, 11, 12], mainly as a consequence of RV pressure overload.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Left ventricular diastolic dysfunction in idiopathic pulmonary fibrosis: a tissue Doppler echocardiographic study

Papadopoulos¹,

Pitsiou²,

Karamitsos³

et al. 2008

European Respiratory Journal

View full text Add to dashboard Cite

It was hypothesised that, apart from right ventricular (RV) dysfunction, patients with idiopathic pulmonary fibrosis (IPF) also exhibit left ventricular (LV) impairment, which may affect disease progression and prognosis. The aim of the present study was to evaluate LV performance in a cohort of IPF patients using conventional and tissue Doppler echocardiography.IPF patients exhibiting mild-to-moderate pulmonary arterial hypertension (mean age 65¡9 yrs; n522) and healthy individuals (mean age 61¡6 yrs; n522) were studied. Conventional and tissue Doppler echocardiography were used for the evaluation of RV and LV systolic and diastolic function.In addition to the expected impairment in RV function, all patients showed a characteristic reversal of LV diastolic filling to late diastole compared with controls (early diastolic peak filling velocity (E)/late diastolic peak filling velocity 0.7¡0.2 versus 1.5¡0.1, respectively). Patients with IPF also exhibited lower peak myocardial velocities in early diastole (Em; 5.7¡1.1 versus 10.3¡1.6 cm?s -1 , respectively), higher in late diastole (Am; 8.9¡1.3 versus 5.5¡0.8 cm?s -1 , respectively), lower Em/Am ratio (0.6¡0.1 versus 1.9¡0.5, respectively) and higher E/Em ratio (10.8¡3 versus 6¡0.6, respectively), all indicative of LV diastolic dysfunction. Moreover, LV propagation velocity was significantly lower in IPF patients (46¡13 versus 83¡21 cm?s -1 , respectively).Physicians should be aware that patients with idiopathic pulmonary fibrosis exhibit early impairment of left ventricular diastolic function.

show abstract

Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Left ventricular diastolic dysfunction in idiopathic pulmonary fibrosis: a tissue Doppler echocardiographic study

Papadopoulos¹,

Pitsiou²,

Karamitsos³

et al. 2008

European Respiratory Journal

View full text Add to dashboard Cite

show abstract

“…13 Paradoxical septal motion is commonly described in patients with pulmonary hypertension and RV pressure overload during echocardiographic examinations 14,15 but rarely reported during myocardial perfusion studies. 16 Interventricular septal flattening is described and reported commonly during echocardiagraphic examinations of patients with significant RV overload [3][4][5][6] but not reported on gated SPECT perfusion studies.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] Myocardial perfusion imaging is not performed for RV overload assessment and the ACC/AHA guidelines for clinical use of cardiac nuclear imaging do not mention any indication for RV function or overload evaluation. 7 Right ventricular overload on myocardial perfusion imaging usually presents with high tracer uptake in the RV wall or increased peak counting method using right to left ventricular peak count ratio.…”

Section: Introductionmentioning

confidence: 99%

Flattening of the interventricular septum (D-shaped left ventricle) in addition to high right ventricular tracer uptake and increased right ventricular volume found on gated SPECT studies strongly correlates with right ventricular overload

Movahed

Hepner

Lizotte

et al. 2005

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

“…The position of the interventricular septum has been evaluated using echocardiography for many years and it is well recognized that diastolic flattening is associated with RV volume overload while systolic flattening reflects RV pressure loading. 3 As such, the same observation on SPECT images is not new and has been used in echocardiography for decades. Regarding Dr Movahed's remarks on using SPECT imaging to evaluate differences between RV and left ventricular perfusion to assess RV hypertrophy RV workload, we agree that SPECT imaging might be of some use to detect pressure overload, but this approach would not be our first-choice imaging modality to make this diagnosis.…”

mentioning

confidence: 96%

The role of SPECT in right ventricular imaging

Mertens

Friedberg

2011

Nat Rev Cardiol

View full text Add to dashboard Cite

We would like to thank Dr Movahed for his interest (Movahed, M. R. Gated SPECT can detect abnormal RV structure or function. Nat. Rev. Cardiol. doi:10.1038/ nrcardio.2010 1 in our recent Review on imaging the right ventricle (Mertens, L. L. & Friedberg, M. K. Imaging the right ventri cle -current state of the art. Nat. Rev. Cardiol. 7, 551-563 (2010)). 2We indeed did not focus on single-photon emission computed tomography (SPECT) imaging, cardiac CT or cardiac angiography to image the right ventricle, as we primarily focused on methods that do not involve ionizing radiation. We believe that techniques involving ionizing radiation are infrequently needed specifically for right ventricular (RV) evaluation unless ultrasound windows are extremely poor and cardiac MRI is contraindicated (for example, when patients have a pacemaker). We agree with Dr Movahed that if SPECT is performed for other indications, such as coronary artery disease, it is worthwhile to include an assessment of the right ventricle in the analysis by SPECT imaging. However, we think that SPECT is rarely indicated as the primary or first-line modality for imaging the right ventricle.Dr Movahed mentions the position of the interventricular septum as a sign of RV pressure overload, and comments on its potential role in the diagnosis of pulmonary embolism in patients with chest pain by SPECT imaging. Dr Movahed writes of a "shift of the interventricular septum toward the left ventricle" as the "Movahed's sign". The position of the interventricular septum has been evaluated using echocardiography for many years and it is well recognized that diastolic flattening is associated with RV volume overload while systolic flattening reflects RV pressure loading.3 As such, the same observation on SPECT images is not new and has been used in echocardiography for decades. Regarding Dr Movahed's remarks on using SPECT imaging to evaluate differences between RV and left ventricular perfusion to assess RV hypertrophy RV workload, we agree that SPECT imaging might be of some use to detect pressure overload, but this approach would not be our first-choice imaging modality to make this diagnosis.

show abstract

Echocardiographic Features of Primary Pulmonary Hypertension

Cited by 114 publications

References 29 publications

Left ventricular diastolic dysfunction in idiopathic pulmonary fibrosis: a tissue Doppler echocardiographic study

Left ventricular diastolic dysfunction in idiopathic pulmonary fibrosis: a tissue Doppler echocardiographic study

Flattening of the interventricular septum (D-shaped left ventricle) in addition to high right ventricular tracer uptake and increased right ventricular volume found on gated SPECT studies strongly correlates with right ventricular overload

The role of SPECT in right ventricular imaging

Contact Info

Product

Resources

About