Imaging in Pulmonary Vascular Disease—Understanding Right Ventricle‐Pulmonary Artery Coupling

Tsarova, Katsiaryna; Morgan, Ashley E.; Melendres‐Groves, Lana; Ibrahim, Maria Salem; Christy, L; Pan, Irene Z.; Hatton, Nathan; Beck, Emily; Ferrel, Meganne; Selzman, Craig H.; Ingram, Dominique; Alamri, Adel A.; Ratcliffe, Mark B.; Wilson, Brent D.; Ryan, John

doi:10.1002/cphy.c210017

Cited by 4 publications

(4 citation statements)

References 111 publications

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“…Recently, the assessment of RVPAC (the simultaneous assessment of RV systolic function and pulmonary artery pressure) has gained clinical importance [21]. Numerous studies have shown that RV contractility, in combination with hemodynamic indices, may provide a more precise assessment of cardiovascular capacity than single parameters [22][23][24]. An example of a parameter that reflects RVPAC well and that has a proven prognostic value in PH is TAPSE/sPAP [25,26].…”

Section: Discussionmentioning

confidence: 99%

Novel Echocardiographic Measurements of Right Ventricular–Pulmonary Artery Coupling in Predicting the Prognosis of Precapillary Pulmonary Hypertension

Topyła-Putowska,

Tomaszewski,

Wojtkowska

et al. 2023

JPM

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Background: Currently, there are many parameters with proven prognostic significance in pulmonary hypertension (PH). Recently, the parameters defining right ventricular–pulmonary artery coupling (RVPAC) have gained clinical importance. In our study, we investigated the prognostic potential of previously known single echocardiographic parameters and new parameters reflecting RVPAC in patients with precapillary PH. Objective: Our study aimed to evaluate the prognostic value of selected echocardiographic parameters and the neutrophil–lymphocyte ratio (NLR) in adults with precapillary PH. Methods: This study included 39 patients (74% women; average age, 63 years) with precapillary PH: pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH). The mean follow-up period was 16.6 ± 13.3 months. Twelve patients (31%) died during the observation time. We measured several echocardiographic parameters, which reflect right ventricular function, pulmonary hemodynamics, and RVPAC. To assess disease progression and the patient’s functional capacity, the World Health Organization functional class (WHO FC) was determined. The patient’s physical capacity was also evaluated using the 6 min walk test (6MWT). The analysis included values of the N-terminal prohormone brain natriuretic peptide (NT-proBNP) and NLR. Results: TAPSE × AcT and TAPSE/sPAP were shown to statistically and significantly correlate with PH predictors, including WHO-FC, 6MWT, and NT-proBNP. Univariate Cox proportional hazards regression analysis revealed that AcT, TAPSE, mPAP, TAPSE/sPAP, RAP, TRPG/AcT, TAPSE × AcT, and NLRs are good predictors of mortality in patients with PH. In addition, the ROC curve analysis showed that TAPSE × AcT is a better predictor of PH-related deaths than TAPSE/sPAP and TAPSE alone. In our study, patients with TAPSE × AcT values < 126.36 had shorter survival times (sensitivity = 72.7%; specificity = 80.0%). Conclusions: TAPSE × AcT is a novel, promising, and practicable echocardiographic parameter reflecting RVPAC, which is comparable to TAPSE/sPAP. Moreover, TAPSE × AcT can be a useful parameter in assessing the severity and prognosis of patients with precapillary PH.

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Section: Discussionmentioning

confidence: 99%

Novel Echocardiographic Measurements of Right Ventricular–Pulmonary Artery Coupling in Predicting the Prognosis of Precapillary Pulmonary Hypertension

Topyła-Putowska,

Tomaszewski,

Wojtkowska

et al. 2023

JPM

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“…1,4 RH imaging can provide detailed information on the structure and function of the RH and its coupling with the pulmonary arterial system. 3 In particular, measurements of RH function such as tricuspid annular plane systolic excursion (TAPSE) and RV fractional area change (RVFAC) reflect changes in ventriculo-arterial coupling and RV function. 5 Measurements of geometry, such as RV area, right atrial (RA) area, and eccentricity, reflect RV dilation.…”

Section: Introductionmentioning

confidence: 99%

“…1 Eventually, the right heart (RH) cannot compensate, uncoupling the RV from the pulmonary arterial tree and leading to morbidity and mortality as RV overload and failure occur. 2,3 Declining RV function and ability to compensate for pulmonary vascular changes are primary determinants of symptoms, clinical status, and survival in patients with PAH. 1,4 RH imaging can provide detailed information on the structure and function of the RH and its coupling with the pulmonary arterial system.…”

Section: Introductionmentioning

confidence: 99%

“…Pulmonary arterial hypertension (PAH) is a chronic, progressive disorder driven by remodeling and proliferation in the pulmonary vasculature, which increase pulmonary vascular resistance and afterload of the right ventricle (RV) 1 . Eventually, the right heart (RH) cannot compensate, uncoupling the RV from the pulmonary arterial tree and leading to morbidity and mortality as RV overload and failure occur 2,3 . Declining RV function and ability to compensate for pulmonary vascular changes are primary determinants of symptoms, clinical status, and survival in patients with PAH 1,4 …”

Section: Introductionmentioning

confidence: 99%

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The heart of the matter: Right heart imaging indicators for treatment escalation in pulmonary arterial hypertension

et al. 2023

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Assessment of Right Ventricular Function—a State of the Art

Hameed

Condliffe

Swift

et al. 2023

Curr Heart Fail Rep

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Purpose of Review The right ventricle (RV) has a complex geometry and physiology which is distinct from the left. RV dysfunction and failure can be the aftermath of volume- and/or pressure-loading conditions, as well as myocardial and pericardial diseases. Recent Findings Echocardiography, magnetic resonance imaging and right heart catheterisation can assess RV function by using several qualitative and quantitative parameters. In pulmonary hypertension (PH) in particular, RV function can be impaired and is related to survival. Summary An accurate assessment of RV function is crucial for the early diagnosis and management of these patients. This review focuses on the different modalities and indices used for the evaluation of RV function with an emphasis on PH.

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Imaging in Pulmonary Vascular Disease—Understanding Right Ventricle‐Pulmonary Artery Coupling

Cited by 4 publications

References 111 publications

Novel Echocardiographic Measurements of Right Ventricular–Pulmonary Artery Coupling in Predicting the Prognosis of Precapillary Pulmonary Hypertension

Novel Echocardiographic Measurements of Right Ventricular–Pulmonary Artery Coupling in Predicting the Prognosis of Precapillary Pulmonary Hypertension

The heart of the matter: Right heart imaging indicators for treatment escalation in pulmonary arterial hypertension

Assessment of Right Ventricular Function—a State of the Art

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