Echocardiographic measurement of right ventricular volume.

Levine, Robert A.; Gibson, Thomas C.; Aretz, Thomas; Gillam, Linda D.; Guyer, David E.; King, Mary Etta; Weyman, Arthur E.

doi:10.1161/01.cir.69.3.497

Cited by 208 publications

(84 citation statements)

References 16 publications

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“…Two-dimensional echocardiography has commonly been used in the management of PH patients. Unfortunately, it has several known limitations including suboptimal windows to delineate RV endocardial borders as well as the fact that the complex and eccentric shape of the right ventricle prevents the use of standard volumetric methods (24). However, TDI has introduced the analysis of regional myocardial velocity and strain, which have proven to be useful (25)(26)(27).…”

Section: Discussionmentioning

confidence: 99%

Differential strain and velocity generation along the right ventricular free wall in pulmonary hypertension

López‐Candales

Rajagopalan

Gulyasy

et al. 2009

Canadian Journal of Cardiology

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T issue Doppler imaging (TDI) has allowed for better quantification of myocardial function by demonstrating specific regional changes in strain generation and in the development of myocardial velocities (1-4). Significant differences in these two TDI indexes (ie, strain and velocity) have been reported for both the right and left ventricles. These differences are likely explained, in part, by the different loading conditions and compliance properties of these two chambers (5,6). However, equally important are the differences noted in myocardial fibre arrangement between the right and left ventricles (7-9). Regardless of the mechanism(s), it has been described that, in contrast to the homogeneously distributed deformation properties within the left ventricle, strain values are inhomogeneously distributed in the right ventricle and show a reverse baso-apical gradient, reaching their highest values toward apical segments and the outflow tract (7,10).Because the Cardiovascular Institute at the University of Pittsburgh (Pittsburgh, Pennsylvania) previously demonstrated that pulmonary hypertension (PH) results in a significant right ventricular (RV) free wall (RVFW) mechanical delay (11), we assessed the effect of the degree of pulmonary arterial systolic pressure (PASP) on the RVFW strain gradient and on myocardial velocity generation to obtain a better understanding of RV failure in PH. METHODS Study populationIn addition to TDI information, complete echocardiographic data, including an acceptable tricuspid regurgitation signal to estimate RV systolic pressure, were recorded in 31 consecutive patients with a history of PH who were referred for an echocardiographic examination. CliniCal StuDieS©2009 Pulsus Group Inc. All rights reserved BACKGROUND:In contrast to the homogeneously distributed deformation properties within the left ventricle, the right ventricular (RV) free wall (RVFW) shows a more inhomogeneous distribution. It has been demonstrated that pulmonary hypertension (PH) results in significant RVFW mechanical delay. OBJECTivE: To assess the effect of the degree of pulmonary arterial systolic pressure on the RVFW strain gradient and on myocardial velocity generation. METHODS: Peak longitudinal strain and velocity data were collected from three different segments (basal, mid-and apical) of the RVFW in 17 normal individuals and 31 PH patients. RESULTS: A total of 144 RV wall segments were analyzed. RVFW strain values in individuals without PH were higher in the mid and apical segments than in the basal segment. In contrast, RVFW strain in PH patients was higher in basal segments and diminished toward the apex. In terms of RVFW velocities, both groups showed decremental values from basal to apical segments. Basal and mid-RVFW velocities were significantly lower in PH patients than in individuals without PH. CONCLUSiONS: PH results in significant alterations of strain and velocity generation that occurs along the RVFW. Of these abnormalities, the reduction in strain from the mid and apical RVFW segments was mos...

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Section: Discussionmentioning

confidence: 99%

Differential strain and velocity generation along the right ventricular free wall in pulmonary hypertension

López‐Candales

Rajagopalan

Gulyasy

et al. 2009

Canadian Journal of Cardiology

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“…20,21 Other noninvasive methods, such as MRI or 3-D echocardiography, can be used accurately to measure end-diastolic and end-systolic volumes and calculate ejection fraction, 4,5 but these methods are time consuming and, more importantly, these indexes are exquisitely load dependent. 22 This is of particular relevance in congenitally malformed hearts, which are often associated with severe RV pressure or volume overload or a combination of both.…”

Section: Indexes Of Contractile Functionmentioning

confidence: 99%

Validation of Myocardial Acceleration During Isovolumic Contraction as a Novel Noninvasive Index of Right Ventricular Contractility

et al. 2002

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Background-We have demonstrated that myocardial acceleration during isovolumic contraction (IVA) is a sensitive index of left ventricular contractile function. In this study, we assessed the utility of IVA to measure right ventricular (RV) contractile function. Methods and Results-We examined 8 pigs by using tissue Doppler imaging of the RV free wall and simultaneous measurements of intraventricular pressure, volume, maximal elastance (e max ), preload recruitable stroke work, and dP/dt max by conductance catheterization. Animals were paced in the right atrium at a rate of 130 beats per minute (bpm).IVA was compared with elastance during contractility modulation by esmolol and dobutamine and during preload reduction and afterload increase by transient balloon occlusion of the inferior vena cava and pulmonary artery, respectively. Data were also obtained during incremental atrial pacing from 110 to 210 bpm. Esmolol led to a decrease in IVA and dP/dt max . During dobutamine infusion, IVA, dP/dt max , preload recruitable stroke work, and e max all increased significantly. During preload reduction and afterload increase, IVA remained constant up to a reduction of RV volume by 54% and an RV systolic pressure increase of 58%. Pacing up to a rate of 190 bpm led to a stepwise increase in IVA and dP/dt max , with a subsequent fall at a pacing rate of 210 bpm. Conclusions-IVA is a measurement of RV contractile function that is unaffected by preload and afterload changes in a physiological range and is able to measure the force-frequency relation. This novel index may be ideally suited to the assessment of acute changes of RV function in clinical studies.

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“…A number of studies have shown it to be a strong predictor of a poor prognosis in HF using the gold standard as RV ejection fraction (RVEF) estimated by cardiovascular magnetic resonance imaging (CMR). [18][19][20] Further knowledge as to the nature of RV …”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Right Ventricular Dimension on Acute Decompensation in Chronic Left-Sided Heart Failure

et al. 2011

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SummaryRight ventricular (RV) dysfunction has been discussed in relation to an adverse outcome in heart failure (HF). The aim of this study was to analyze the relationship between RV function with HF exacerbation and its subsequent longterm outcome in patients with chronic left-sided HF.We studied 122 consecutive patients who were admitted for dyspnea due to exacerbated left-sided HF with a left ventricular (LV) ejection fraction of less than 40%. Conventional echocardiography was performed in the study subjects on admission and at discharge. Cox proportional hazards analysis revealed that RV end-diastolic dimension (RVDd) (hazard ratio 1.131, P = 0.005, 95% confidence interval 1.039-1.231) and the serum level of creatinine on admission were independent predictors of subsequent cardiac-related death, but RVDd at discharge and other LV parameters were not. Thus, patients were divided into tertiles on the basis of RVDd on admission: < 32 mm (n = 37), 32-40 mm (n = 43), and ≧ 40 mm (n = 42). According to the increase in the RVDd category, the cardiac-related death-free rate significantly decreased. Among the 3 groups, the pulse pressure and serum total bilirubin levels that demonstrated low cardiac output syndrome (LOS) parameters had significant differences.RVDd on admission could be measured noninvasively and easily to predict a worse long-term prognosis of chronic left-sided HF on admission, and showed correlations with LOS parameters. (Int Heart J 2011; 52: 119-126)

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Echocardiographic measurement of right ventricular volume.

Cited by 208 publications

References 16 publications

Differential strain and velocity generation along the right ventricular free wall in pulmonary hypertension

Differential strain and velocity generation along the right ventricular free wall in pulmonary hypertension

Validation of Myocardial Acceleration During Isovolumic Contraction as a Novel Noninvasive Index of Right Ventricular Contractility

Prognostic Significance of Right Ventricular Dimension on Acute Decompensation in Chronic Left-Sided Heart Failure

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