Serial assessment of right ventricular systolic function in patients with precapillary pulmonary hypertension using simple echocardiographic parameters: A comparison with cardiac magnetic resonance imaging

Spruijt, Onno A.; Pasqua, Maria Concetta Di; Bogaard, Harm Jan; Bruggen, Cathelijne E. E. van der; Oosterveer, Frank; Marcus, J. Tim; Vonk‐Noordegraaf, Anton; Handoko, M. Louis

doi:10.1016/j.jjcc.2016.02.019

Cited by 25 publications

(24 citation statements)

References 17 publications

(22 reference statements)

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“…In a recent report by Spruijt et al, associations between changes in echocardiographic and CMRI indices were examined in 38 PH patients. [ 19 ] Similar to the present study, their study exhibited significant associations between CMRI-derived RVEF and four echocardiographic indices of RV function (i.e., TAPSE, %RV area change, fractional longitudinal wall motion, and transverse wall motion). However, the sensitivities of these indices in detecting a decline in CMRI-derived RVEF were low at 33% to 56% and the authors concluded that such parameters were not suitable for serial assessment of RV systolic function in precapillary PH patients.…”

Section: Discussionsupporting

confidence: 86%

“…[ 17 ] However, echocardiography is known to encounter a challenge in obtaining clear images, particularly in PH patients with a severely dilated right heart or comorbid advanced lung disease. [ 18 ] In addition, most previous studies were cross-sectional in nature, and only a few have examined the accuracy of serial monitoring of echocardiographic indices of RV systolic function[ 19 ]. With the remarkable progress in the treatments of PH, there is a need for the development of simple, noninvasive, and reproducible methods to assess RV function in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of echocardiographic indices for serial monitoring of right ventricular systolic function in patients with precapillary pulmonary hypertension

et al. 2017

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BackgroundSerial assessment of right ventricular ejection fraction (RVEF) predicts the clinical outcome of patients with pulmonary hypertension (PH). Cardiac magnetic resonance imaging (CMRI) enables RVEF monitoring, but its applicability is limited in clinical practice. This study aimed to examine the correlation between changes in CMRI-derived RVEF with those in echocardiographic indices in patients with precapillary PH.MethodsCMRI and echocardiographic indices of RV systolic function were evaluated at baseline and follow-up in 54 consecutive patients with precapillary PH (pulmonary arterial hypertension (PAH), n = 23; non-PAH, n = 31). During follow-up, medical treatment was optimized according to the guidelines for PH. Using CMRI-derived RVEF as the gold standard, we examined the accuracy of five echocardiographic indices by correlation analysis and receiver operating characteristic (ROC) analysis and by calculating sensitivity, specificity, and positive and negative predictive values.ResultsAfter an average period of 9.5 months, CMRI-derived RVEF improved from 30.2% ± 10.6% at baseline to 41.4% ± 11.3% at follow-up. These changes significantly correlated with those in the five echocardiographic indices, i.e., %RV fractional shortening (r = 0.27), %RV area change (r = 0.46), tricuspid annular plane systolic excursion (TAPSE) (r = 0.84), RV myocardial performance index (RVMPI) (r = −0.72), and systolic lateral tricuspid annular motion velocity (TVlat) (r = 0.66). Of these indices, %RV area change, TAPSE, and TVlat significantly correlated with those of CMRI-derived RVEF in both PAH and non-PAH subgroups. ROC analysis showed that improvement in echocardiographic indices predicted a pre-specified improvement in CMRI-derived RVEF (>2.9%), with TAPSE and TVlat showing better accuracy over the other three indices.ConclusionsEchocardiographic indices modestly correlate with the changes in CMRI-derived RVEF in precapillary PH patients. Comparison among the five echocardiographic indices revealed that TAPSE and TVlat provide better accuracy than %RV fractional shortening, %RV area change, and RVMPI.

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Accuracy of echocardiographic indices for serial monitoring of right ventricular systolic function in patients with precapillary pulmonary hypertension

et al. 2017

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“…Right atrium (RA) area was measured in the apical four-chamber view at end-systole, by tracing the RA blood-tissue interface [15]. Tricuspid annular plane systolic excursion (TAPSE) was calculated as index of RV longitudinal systolic function by placing an M-mode cursor through the tricuspid annulus in a standard apical four-chamber window, and measuring the difference between end-diastolic and end-systolic amount of longitudinal motion of the annulus (in mm) [22,23].…”

Section: M-and B-mode Measurementsmentioning

confidence: 99%

The impact of age and gender on right ventricular diastolic function among healthy adults

D’Andrea

Vriz

Carbone

et al. 2017

Journal of Cardiology

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“…However, echocardiography is operator dependent and the image quality is often inadequate, especially for the RV (7) . Therefore, evaluation of the RV ejection fraction (RVEF) through the use of cardiac magnetic resonance imaging (MRI) has emerged as the gold standard for the assessment of RV function (8) .…”

Section: Introductionmentioning

confidence: 99%

Relationship between right atrium area and right ventricular ejection fraction on magnetic resonance imaging: comparison with other prognostic markers in patients with pulmonary arterial hypertension

et al. 2019

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Objective: To compare the right atrium (RA) area and right ventricular ejection fraction (RVEF) with other known prognostic markers in patients with pulmonary arterial hypertension (PAH). Materials and Methods: This was a retrospective study of 74 patients diagnosed with PAH by right heart catheterization at a referral center between January 2018 and May 2018. All of the patients underwent cardiac magnetic resonance imaging (MRI) within 3 months of the right heart catheterization (RHC), as well as undergoing echocardiography, a 6-minute walk test, and determination of the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) within a month of the RHC. We attempted to determine whether the cardiac MRI-derived RA area correlated with ions between RVEF and RA area measured by that determined by echocardiography, as well as whether the cardiac MRI-derived RA area and RVEF correlated with the 6-minute walk distance and NT-proBNP level. Results: The MRI-derived RA area demonstrated a weak correlation with the pulmonary vascular resistance measured by RHC (r = 0.268; p = 0.055) and a moderate correlation with the NT-proBNP (r = 0.429; p = 0.003). All correlations between clinical characteristics and the RVEF were statistically significant. In the univariate linear analysis, the RVEF showed stronger correlations with the clinical characteristics than did the RA area. Conclusion: In patients with PAH, cardiac MRI-derived RVEF appears to correlate more strongly with other prognostic factors than does RA area.

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Serial assessment of right ventricular systolic function in patients with precapillary pulmonary hypertension using simple echocardiographic parameters: A comparison with cardiac magnetic resonance imaging

Cited by 25 publications

References 17 publications

Accuracy of echocardiographic indices for serial monitoring of right ventricular systolic function in patients with precapillary pulmonary hypertension

Accuracy of echocardiographic indices for serial monitoring of right ventricular systolic function in patients with precapillary pulmonary hypertension

The impact of age and gender on right ventricular diastolic function among healthy adults

Relationship between right atrium area and right ventricular ejection fraction on magnetic resonance imaging: comparison with other prognostic markers in patients with pulmonary arterial hypertension

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