Right ventricular remodelling in mild hypertensive patients: role of left ventricular morpho-functional parameters

Maresca, Andrea Maria; Mongiardi, C.; Corso, Rossana; Test, L. Robustelli; Lippi, A.; Montalbetti, L.; Campiotti, Leonardo; Moretti, S; Tandurella, N.; Agostinis, M.; Grandi, Anna Maria; Guasti, Luigina

doi:10.1038/s41371-019-0185-z

Cited by 7 publications

(9 citation statements)

References 27 publications

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“…The RV contributes significantly to the normal cardiac output response to exercise, as demonstrated by the 30–40% decrease in maximum oxygen uptake in young patients with Fontan physiology compared with healthy controls [ 21 ]. Ventricular interdependence has also been implicated in the development of RV remodeling in untreated asymptomatic mild hypertensive patients, and has been attributed to changes in IVS structure [ 22 ].…”

Section: Ivs Functionmentioning

confidence: 99%

The Interventricular Septum: Structure, Function, Dysfunction, and Diseases

Triposkiadis

Xanthopoulos

Boudoulas

et al. 2022

JCM

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Vertebrates developed pulmonary circulation and septated the heart into venous and arterial compartments, as the adaptation from aquatic to terrestrial life requires more oxygen and energy. The interventricular septum (IVS) accommodates the ventricular portion of the conduction system and contributes to the mechanical function of both ventricles. Conditions or diseases that affect IVS structure and function (e.g., hypertrophy, defects, other) may lead to ventricular pump failure and/or ventricular arrhythmias with grave consequences. IVS structure and function can be evaluated today using current imaging techniques. Effective therapies can be provided in most cases, although definitions of underlying etiologies may not always be easy, particularly in the elderly due to overlap between genetic and acquired causes of IVS hypertrophy, the most common being IVS abnormality. In this review, state-of-the-art information regarding IVS morphology, physiology, physiopathology, and disease is presented.

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Section: Ivs Functionmentioning

confidence: 99%

The Interventricular Septum: Structure, Function, Dysfunction, and Diseases

Triposkiadis

Xanthopoulos

Boudoulas

et al. 2022

JCM

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“…Differential changes to RV geometry have been documented previously in patients with pulmonary hypertension including severe MR 18 as well as in mildly hypertensive patients. 19 The former is more pertinent to this study and poses a risk for over encumbering RVEF/E as a driver of mortality rather than significant MR in this study group. This highlights a potentially significant confounder.…”

Section: Discussionmentioning

confidence: 92%

“… 17 In short, the RV volume is calculated by assuming both left and right ventricles are parts of two ellipsoids with 3 common radii which can easily be measured on standard 2D TTE. Given that cardiac remodeling affects both ventricles in other conditions including valvular HF 18 , 19 we have assumed that such model is valid for patients with acute HF. It is, however, not known if such estimation of RVEF provides similar prognostic value compared to conventional 2D echo parameters.…”

Section: Introductionmentioning

confidence: 99%

Right ventricular ejection fraction as predictor of outcome in acute heart failure using RV ellipsoid model: A retrospective analysis of a prospective cross-sectional study

Ashcroft

Lazariashvili

Belsey³

et al. 2021

JRSM Cardiovascular Disease

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Objectives The right ventricular (RV) function is an important prognostic factor in acute and chronic heart failure (HF). Echocardiography is an essential imaging modality with established parameters for RV function which are useful and easy to perform. However, these fail to reflect global RV volumes due to reliability on one acoustic window. It is therefore attractive to calculate RV volumes and ejection fraction (RVEF/E) using an ellipsoid geometric model which has been validated against MRI in healthy adults but not in the HF patients. Design This is a retrospective analysis of a prospective cross-sectional study enrolling 418 consecutive patients with symptoms of HF according to a predefined study protocol. All patients underwent echocardiographic assessment of RV function using Tricuspid Annular Plane Systolic Excursion (TAPSE) and RV fractional area change (RVFAC) and RVEF/E. Setting Single centre study with multiple locations for acute in-patients including high dependency units. Participants Patients with acute or exacerbation of chronic HF older than 18 y.o. Main outcome measures Ability of RVEF/E to predict patient outcomes compared with two established parameters of RV function over two-year follow-up period. Primary outcome measure was all-cause mortality. Results RVEF/E is equal to TAPSE & RVFAC in predicting outcome (p ≤ 0.01 vs p ≤ 0.01) and provides additional benefit of RV volume estimation based on standard 2D echo measurements. Conclusions In this study we have shown that RVEF/E derived from ellipsoid model is not inferior to well established measures of RV function as a prognostic indicator of outcome in the acute HF.

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“…Previous studies have shown that the level of physical activity [22], smoking [23] and the left ventricular hypertrophy [12,24] affect the right ventricle. It was previously shown that healthy residents of highlands have small left heart and large right ventricle due to exposure to hypoxemia at high altitudes, and these changes did not depend on ethnicity [25].…”

Section: Discussionmentioning

confidence: 99%

“…Assessment of right ventricular (RV) function is still insu ciently studied in patients with arterial hypertension, despite the rst information about its dysfunction in hypertension being obtained over 30 years ago [11]. Researchers are currently studying the factors associated with RV remodeling in hypertension [12] and have already shown an independent effect of RV parameters on the prognosis in these patients [13]. Distinguishing between normal and abnormal right heart dimensions and functions is therefore clinically relevant.…”

Section: Introductionmentioning

confidence: 99%

Ethnic differences in right ventricular structure and function in urbanized hypertensive patients in the Gornaya Shoriya region

Сумин

Gomozova

Щеглова

et al. 2022

Preprint

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Objective of this study was to compare right ventricular echocardiography parameters in urbanized hypertensive patients of the Shor and non-indigenous ethnic groups in the Mountain Shoria region. Methods The study included patients with arterial hypertension: 58 Shors and 50 non-indigenous urbanized residents, comparable in age, and divided by ethnicity and gender into 4 groups: Shors men (n = 20), Shors women (n = 38), non-indigenous men (n = 15) and non-indigenous women (n = 35). All underwent echocardiographic examination, and the right heart parameters were studied. Results Shor men with arterial hypertension had the lowest values of the pulmonary artery index, the right atrium dimensions, and the highest values of the blood flow velocity in the right ventricle, et' and st' in comparison with non-indigenous men. Shor women have the lowest values Et and Et/At ratios. RV diastolic dysfunction was detected mainly in women, somewhat more often in Shors. Ethnicity was one of the factors associated with the right ventricular diastolic dysfunction presence. Among the factors associated with the RV diastolic dysfunction were risk factors (smoking, obesity), blood pressure, gender, ethnicity, and left ventricular parameters (diastolic dysfunction and the myocardial mass increase). Conclusion Our study established the influence of ethnic differences on the right heart echocardiographic parameters in Shors and Caucasians with arterial hypertension. The revealed differences should improve the assessment of the right heart structure and function in patients with arterial hypertension from small ethnic groups, which will help to improve the diagnosis and treatment of such patients.

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Right ventricular remodelling in mild hypertensive patients: role of left ventricular morpho-functional parameters

Cited by 7 publications

References 27 publications

The Interventricular Septum: Structure, Function, Dysfunction, and Diseases

The Interventricular Septum: Structure, Function, Dysfunction, and Diseases

Right ventricular ejection fraction as predictor of outcome in acute heart failure using RV ellipsoid model: A retrospective analysis of a prospective cross-sectional study

Ethnic differences in right ventricular structure and function in urbanized hypertensive patients in the Gornaya Shoriya region

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