Right ventricular systolic function assessment: rank of echocardiographic methods vs. cardiac magnetic resonance imaging

Pavlicek, Michael; Wahl, Andreas; Rutz, Tobias; Marchi, Stefano F. de; Hille, Ron; Wustmann, Kerstin; Steck, Hélène; Eigenmann, Christina; Schwerzmann, Markus; Seiler, Christian

doi:10.1093/ejechocard/jer138

Cited by 135 publications

(149 citation statements)

References 24 publications

Supporting

Mentioning

133

Contrasting

Unclassified

Order By: Relevance

“…Our own experience and that of other authors has found fractional area change to suffer from large interobserver variations [33], often the result of difficulty in clearly defining endocardial borders due to RV trabeculations. Furthermore, accurate measurement of RV area is limited by the complex geometry of this chamber.…”

Section: Limitationsmentioning

confidence: 69%

Dobutamine stress for evaluation of right ventricular reserve in pulmonary arterial hypertension

et al. 2014

View full text Add to dashboard Cite

Right ventricular contractile response to pharmacological stress in pulmonary arterial hypertension (PAH) has not been characterised. We evaluated right ventricular contractile reserve in adults with PAH using dobutamine stress echocardiography.16 PAH patients and 18 age-matched controls underwent low-dose dobutamine stress echocardiography. Contractile reserve was assessed by the change (Δ; peak stress minus rest value) in tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (S′). A subgroup of 13 PAH patients underwent treadmill cardiopulmonary exercise testing for peak oxygen uptake (V′O 2 peak).At rest, TAPSE and S′ were reduced in the PAH group compared with controls (1.7±0.4 versus 2.4±0.2 cm and 9.7±2.6 versus 12.5±1.2 cm·s −1 , respectively; p<0.05). Contractile reserve was markedly attenuated in PAH compared to controls (ΔTAPSE 0.1±0.2 versus 0.6±0.3 cm and ΔS′ 4.6±2.8 versus 11.2±3.6 cm·s −1 ; p<0.0001). In the sub-group of PAH patients with preserved right ventricular systolic function at rest, contractile reserve remained depressed compared to controls. V′O 2 peak was significantly correlated with ΔS′ (r=0.87, p=0.0003) and change in stroke volume (r=0.59, p=0.03).Dobutamine stress can reveal sub-clinical reduction in right ventricular contractile reserve in patients with PAH. A correlation with exercise capacity suggests potential clinical value beyond resting measurements. @ERSpublications Dobutamine-induced right ventricular contractile reserve is impaired in PAH and correlates with exercise capacity

show abstract

Section: Limitationsmentioning

confidence: 69%

Dobutamine stress for evaluation of right ventricular reserve in pulmonary arterial hypertension

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Significant improvement of RVFAC after LVAD implantation may attenuate the association between RVFAC and residual TR. Furthermore, RVFAC emerged as a poor parameter for the determination of RV contractility in recent studies,29, 30 suggesting that, in the presence of TR, estimates of radial contraction may misdiagnose the presence of RV dysfunction because of the decrease in RV afterload caused by the leaking valve, just as the LVEF assessment is limited by MR 13. Tricuspid annular plane systolic excursion, RV index of myocardial performance and/or assessment using 3‐dimensional echocardiography may provide additional information of RV contractility and its association with residual TR 30, 31.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, Predictors, and Prognostic Value of Residual Tricuspid Regurgitation in Patients With Left Ventricular Assist Device

Nakanishi

Homma

Han

et al. 2018

JAHA

View full text Add to dashboard Cite

BackgroundAlthough implantation of a left ventricular assist device (LVAD) generally improves tricuspid regurgitation (TR) in short‐term follow‐up, the clinical significance of residual TR in patients with mid‐ to long‐term LVAD support is unknown. This study aimed to identify the prevalence, predictors, and prognostic value of residual TR in LVAD patients in association with tricuspid valve (TV) deformation.Methods and ResultsThe study cohort consisted of 127 patients who underwent LVAD implantation without TV procedure and were supported with LVAD at least 1 year. All patients underwent echocardiographic examination preoperatively and 1 year after LVAD implantation. TR was quantitatively assessed by ratio of TR color jet area/right atrial area, and significant residual TR was defined as ≥20% of %TR at follow‐up echocardiographic examination. Detailed echocardiographic measurements were also performed, including TV annulus diameter, TV leaflet displacement, and left ventricular and right ventricular systolic function. LVAD implantation significantly improved ratio of TR color jet area/right atrial area as well as left ventricular and right ventricular systolic function and tethering distance (all P<0.05), whereas it enlarged TV annulus diameter (P=0.002). Significant residual TR was observed in 30 (23.6%) patients. Age, preoperative TV annulus diameter, and residual mitral regurgitation were significantly associated with significant residual TR (all P<0.05), whereas TV tethering was not. During a mean follow‐up of 21±17 months, patients with residual TR had significantly higher mortality than those without residual TR (log‐rank P<0.001).ConclusionsSignificant residual TR was observed in ≈25% patients supported with LVAD over 1 year and was associated with unfavorable outcome.

show abstract

“…Figure 6). RVFAC expresses the percentage change of the calculated right ventricular areas between the enddiastole right ventricular area (the end of the part of the cardiac cycle when the heart relaxes, when the heart is at its biggest) and end-systole right ventricular area (the end of the cardiac contraction, when the heart is at its smallest) (Pavlicek et al 2011; P. C. Frommelt et al 2012).…”

Section: Interstage Mortalitymentioning

confidence: 99%

“…The gold standard method to measure right ventricular ejection fraction is cardiac magnetic resonance imaging (MRI) and normal values of RVEF measured by MRI are 49 % to 72 % (Pavlicek et al 2011;Larose et al 2007). Unfortunately, MRI was only performed on a subgroup of patients for the SVR trial.…”

Section: Right Ventricular Function Measurementsmentioning

confidence: 99%

Risk Factors for Death or Heart Transplant for Patients with Right Ventricular Dysfunction After the Norwood Procedure: A Secondary Analysis of the Single Ventricle Reconstruction Trial

Jean‐St‐Michel

Meza

Coles

et al. 2017

The Journal of Heart and Lung Transplantation

View full text Add to dashboard Cite

We investigated patient and procedural factors associated with failure of staged palliation after the Norwood procedure in patients with right ventricular dysfunction (RVDfx).Patients from the Pediatric Heart Network Single Ventricle Reconstruction (SVR) Trial dataset were selected if RVDfx was present, defined as an ejection fraction of less than 44% and a fractional area of change of less than 35% on the post-Norwood echocardiogram. Transplantfree survival after the Norwood procedure was analyzed using multiphase parametric hazard analysis and factors associated with death or transplant were identified.In the SVR cohort, 123 (34%) infants had RVDfx. The six-month transplant-free survival was 87% (70%CI 82-91%). The independent factors associated with increased risk of death or transplant were BT shunt, increased RV size, infectious disease complications and low surgeon volume.Patient factors can help identify which patient with RVDfx is at higher risk of death and help decision making around early transplant listing.iii

show abstract

Right ventricular systolic function assessment: rank of echocardiographic methods vs. cardiac magnetic resonance imaging

Abstract: A systolic long-axis peak velocity of <11 cm/s at the lateral tricuspid annulus most accurately detects moderately impaired RVEF as obtained by MRI; severely reduced RVEF ≤30% is best detected by RV MPI at a value of >0.50.

Cited by 135 publications

References 24 publications

Dobutamine stress for evaluation of right ventricular reserve in pulmonary arterial hypertension

Dobutamine stress for evaluation of right ventricular reserve in pulmonary arterial hypertension

Prevalence, Predictors, and Prognostic Value of Residual Tricuspid Regurgitation in Patients With Left Ventricular Assist Device

Risk Factors for Death or Heart Transplant for Patients with Right Ventricular Dysfunction After the Norwood Procedure: A Secondary Analysis of the Single Ventricle Reconstruction Trial

Contact Info

Product

Resources

About