Prognostic Value of Right Ventricular Two-Dimensional and Three-Dimensional Speckle-Tracking Strain in Pulmonary Arterial Hypertension: Superiority of Longitudinal Strain over Circumferential and Radial Strain

Li, Yuman; Wang, Tao; Haines, Philip; Li, Mengmei; Wu, Wenqian; Liu, Manwei; Chen, Yihan; Jin, Qiaofeng; Xie, Yuji; Wang, Jing; Yang, Yali; Zhang, Li; Lv, Qing; Xie, Mingxing

doi:10.1016/j.echo.2020.03.015

Cited by 41 publications

(43 citation statements)

References 23 publications

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“…Among them, RV 2D-STE analysis has been demonstrated to show the capability to quantify RV mechanics and provide prognostic information (10,(24)(25)(26)(27)(28). In a study of patients with HF with reduced ejection fraction (HFrEF), Motoki et (12,20,21). Moreover, very few studies performed head-to-head comparisons of 2D-STE and 3D-STE in RV function evaluation.…”

Section: Prognostic Value Of Rv 2d-and 3d-ste Parametersmentioning

confidence: 99%

“…Recently, two-dimensional (2D) speckle tracking echocardiography (STE) has been considered to be a sensitive, reliable quantitative technique for RV function assessment (7)(8)(9). Furthermore, growing evidence suggests that RV longitudinal strain of free wall (RV FWLS) derived from 2D-STE provides incremental prognostic information over standard RV parameters in varying clinical settings, including patients with pulmonary arterial hypertension, HF with reduced ejection fraction, or coronavirus disease-2019 (10)(11)(12). However, 2D-STE analysis has some primary limitations, such as foreshortened views, geometric modeling, and out-of-plane motion of the speckles.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Value of Right Ventricular 3D Speckle-Tracking Strain and Ejection Fraction in Patients With HFpEF

Meng

Zhu

Xie

et al. 2021

Front. Cardiovasc. Med.

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Background: Right ventricular longitudinal strain of free wall (RV FWLS) assessed by two-dimensional speckle-tracking echocardiography (2D-STE) is recognized as an independent predictor of poor prognosis in patients with heart failure with preserved ejection fraction (HFpEF). However, the prognostic implications of three-dimensional STE (3D-STE) parameters in patients with HFpEF have not been well-established. The purpose of our study was to determine whether 3D-STE parameters were the more powerful predictors of poor outcomes in HFpEF patients compared with 2D-STE indices.Methods: Eighty-one consecutive patients with HFpEF were studied by 2D-STE and 3D-STE. RV volumes, ejection fraction (EF) and 3D-RVFWLS were measured by 3D-STE. 2D-RVFWLS was determined by 2D-STE. Patients were followed for the primary end point of heart failure (HF)-related hospitalization and death for HF.Results: After a median follow-up period of 17 months, 39 (48%) patients reached the end point of cardiovascular events. Compared with HFpEF patients without end-point events, those with end-point events had lower RVEF and 3D-RVFWLS (P < 0.05). Separate multivariate Cox regression analyses revealed that 3D-RVFWLS (HR 5.73; 95% CI 2.77–11.85; P < 0.001), RVEF (HR 3.47; 95% CI 1.47–8.21; P = 0.005), and 2D-RVFWLS (HR 3.17; 95% CI 1.54–6.53; P = 0.002) were independent predictors of adverse outcomes. The models with 3D-RVFWLS (AIC = 246, C-index = 0.75) and RVEF (AIC = 247, C-index = 0.76) had similar predictive performance for future clinical events as with 2D-RVFWLS (AIC = 248, C-index = 0.74).Conclusions: 3D-STE parameters are powerful predictors of poor outcomes, providing a similar predictive value as 2D-STE indices in patients with HFpEF. These findings support the potential of RV 3D-STE to identify HFpEF patients at higher risk for adverse cardiac events.

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Section: Prognostic Value Of Rv 2d-and 3d-ste Parametersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Right Ventricular 3D Speckle-Tracking Strain and Ejection Fraction in Patients With HFpEF

Meng

Zhu

Xie

et al. 2021

Front. Cardiovasc. Med.

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“…Two-dimensional (2D) speckle tracking echocardiography (STE)-derived RV strain is a measure of myocardial deformation, and is useful in the evaluation of the function of the right heart, as it is independent of endocardial border tracings and geometric assumptions [53]. The systolic function of the RV relies heavily on its longitudinal contraction, acting more or less like a piston pump; thus, the longitudinal strain-rather than the circumferential or radial strain-is the preferable parameter to measure [54]. RV longitudinal systolic strain (RV LSS) is a very useful marker of subclinical deterioration, even before conventional measures-such as the TAPSE-deteriorate.…”

Section: Echocardiographic Evaluation Of Right Ventricular Function and Its Prognostic Relevance In Pahmentioning

confidence: 99%

Echocardiography in Pulmonary Arterial Hypertension: Is It Time to Reconsider Its Prognostic Utility?

Farmakis

Demerouti

Karyofyllis

et al. 2021

JCM

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Pulmonary arterial hypertension (PAH) is characterized by an insult in the pulmonary vasculature, with subsequent right ventricular (RV) adaptation to the increased afterload that ultimately leads to RV failure. The awareness of the importance of RV function in PAH has increased considerably because right heart failure is the predominant cause of death in PAH patients. Given its wide availability and reduced cost, echocardiography is of paramount importance in the evaluation of the right heart in PAH. Several echocardiographic parameters have been shown to have prognostic implications in PAH; however, the role of echocardiography in the risk assessment of the PAH patient is limited under the current guidelines. This review discusses the echocardiographic evaluation of the RV in PAH and during therapy, and its prognostic implications, as well as the potential significant role of repeated echocardiographic assessment in the follow-up of patients with PAH.

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“…Критерии включения/исключения. В систематический обзор включены только те исследования, в которых были адекватно представлены исходные дан- [20]. RV FW LS (2D/3D) рассчитывается как среднее значение от суммы 3 сегментов свободной стенки ПЖ: на базальном, среднем и верхушечном уровнях.…”

Section: материал и методыunclassified

Right ventricular free-wall longitudinal speckle tracking strain as a prognostic criterion of adverse outcomes in patients with pulmonary hypertension: a systematic review and meta-analysis

et al. 2021

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The absence of consensus regarding the reference values of right ventricular free wall longitudinal strain (RVFWLS) and its predictive value prompted us to conduct a systematic review and meta-analysis of publications on the predictive role of this parameter in patients with pulmonary hypertension (PH).Aim. To study the independent predictive value of RVFWLS in PH patients using 2D/3D speckle tracking echocardiography.Material and methods. Firstly, 317 publications (PubMed) and 857 Google Scholar results were selected. Of the initially identified search results, 12 articles were analyzed. The papers were cohort designed.Results. The total number of patients with PH was 1281. The mean age of patients was 54,7±6,8 years. Four studies compared the RVFWLS with a control group (n=251). The mean RVFWLS were -17,0±2,4% and -24,7±2,2% in the experimental and control groups, respectively. A meta-analysis of the difference between the mean RVFWLS values in experimental and control group patients showed its total increase in PH subjects of 8,06% (95% CI: 5,18-10,94%; p<0,00001).The total number of deaths was 268 (all-cause — 180, composite endpoint — 88). According to the meta-analysis, with an increase of 1% in RVFWLS, there is an increase in mean all-cause mortality risk by 14% (p<0,00001), as well as mean risk of adverse outcomes or PH-related events (composite endpoint) by 14% (p<0,0001).Conclusion. These results highlight the high independent predictive value of RVFWLS as a predictor of adverse outcomes or events associated with a right ventricular dysfunction progression in PH patients.

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Prognostic Value of Right Ventricular Two-Dimensional and Three-Dimensional Speckle-Tracking Strain in Pulmonary Arterial Hypertension: Superiority of Longitudinal Strain over Circumferential and Radial Strain

Cited by 41 publications

References 23 publications

Prognostic Value of Right Ventricular 3D Speckle-Tracking Strain and Ejection Fraction in Patients With HFpEF

Prognostic Value of Right Ventricular 3D Speckle-Tracking Strain and Ejection Fraction in Patients With HFpEF

Echocardiography in Pulmonary Arterial Hypertension: Is It Time to Reconsider Its Prognostic Utility?

Right ventricular free-wall longitudinal speckle tracking strain as a prognostic criterion of adverse outcomes in patients with pulmonary hypertension: a systematic review and meta-analysis

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