Right Heart Function in Scleroderma: Insights from Myocardial Doppler Tissue Imaging

Hsiao, Shih-Hung; Lee, Chiu-Yen; Su, Chang; Lin, Shih-Kai; Liu, Chun–Peng

doi:10.1016/j.echo.2005.12.003

Cited by 55 publications

(43 citation statements)

References 36 publications

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“…1). This result was inconsistent with previous reports that showed a significantly negative correlation between % DLCO and PAP in patients with SSc (26,27 …”

Section: Pulmonary Function Testscontrasting

confidence: 99%

Incidence of Pulmonary Hypertension and Its Clinical Relevance in Patients with Interstitial Pneumonias: Comparison between Idiopathic and Collagen Vascular Disease Associated Interstitial Pneumonias

et al. 2007

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“…1). This result was inconsistent with previous reports that showed a significantly negative correlation between % DLCO and PAP in patients with SSc (26,27 …”

Section: Pulmonary Function Testscontrasting

confidence: 99%

Incidence of Pulmonary Hypertension and Its Clinical Relevance in Patients with Interstitial Pneumonias: Comparison between Idiopathic and Collagen Vascular Disease Associated Interstitial Pneumonias

et al. 2007

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“…Although other RV TDI studies of patients with PH have not made any particular distinction of these differences, most of these studies combined values from different regions of the right ventricle when reporting their results (38)(39)(40)(41).…”

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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“…PAP by echo-Doppler was independently correlated with tricuspid E/A ratio, an index of the right ventricular relaxation (r = -0.35, p < 0.003, by multiple regression analysis) [32]. No correlation was found between PASP and right ventricular ejection fraction (RVEF) [20] In summary, only an association between the presence of pericardial effusion on echo and survival/mortality, was supported with the highest quality study (level A1) [19]. For this aspect of the construct validity, echo was rated as validated.…”

Section: Construct Validitymentioning

confidence: 97%

“…One study (quality level B2), including SSc patients with and without PH, showed a low intra-and interobserver variability in evaluation of right ventricular ejection fraction and left ventricular ejection fraction (range from 3.5% to 5.3%, depending on the parameters) [20].…”

Section: Reliabilitymentioning

confidence: 99%

Echocardiography as an Outcome Measure in Scleroderma-related Pulmonary Arterial Hypertension: A Systematic Literature Analysis by the EPOSS Group

Kowal-Bielecka¹,

Avouac²,

Pittrow³

et al. 2009

J Rheumatol

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Lewis J Rubin has received consulting income from Actelion and Encysive; and he has served as an investigator for Actelion and Encysive. James R. Seibold, has consultancy relationships and research funding from Actelion, Pfizer, Encysive, FibroGen, Centocor, Bristol-Myers Squibb, Genzyme, Lilly, Gilead and United Therapeutics in the area of potential treatments of scleroderma and its complications. He has received lecture honoraria from Actelion, Pfizer, Encysive and United Therapeutics. His spouse is a full-time employee of Actelion Vibeke Strand has consultancy relationships with Pfizer, FibroGen, and Bristol-Myers Squibb in the area of potential treatments of scleroderma and its complications Daniel E Furst has consultancy relationship, has been a member of scientific advisory board, and/or has received research funding from Abbott, Actelion, Amgen, BMS, BiogenIdec, Centocor, Genentech, Gilead, GSK, Merck, Nitec, Novartis, Roche, UCB, Wyeth and Xoma. He has received lecture honoraria and/or lectured on behalf of Abbott, Actelion, Amgen, BMS, Biogen, Biogenidec, Centocor, Genentech, Gilead, Merck, Nitec and UCB. Oliver Distler has consultancy relationships and/or has received research funding from Actelion, Pfizer, Encysive, FibroGen, Ergonex, NicOx, and Biovitrum in the area of potential treatments of scleroderma and its complications. He has received lecture honoraria from Actelion, Pfizer, Encysive and Ergonex.This study was partially supported by unrestricted educational grants from Actelion,

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Right Heart Function in Scleroderma: Insights from Myocardial Doppler Tissue Imaging

Cited by 55 publications

References 36 publications

Incidence of Pulmonary Hypertension and Its Clinical Relevance in Patients with Interstitial Pneumonias: Comparison between Idiopathic and Collagen Vascular Disease Associated Interstitial Pneumonias

Incidence of Pulmonary Hypertension and Its Clinical Relevance in Patients with Interstitial Pneumonias: Comparison between Idiopathic and Collagen Vascular Disease Associated Interstitial Pneumonias

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

Echocardiography as an Outcome Measure in Scleroderma-related Pulmonary Arterial Hypertension: A Systematic Literature Analysis by the EPOSS Group

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