Differences in right ventricular morphology, not function, indicate the nature of increased afterload in pulmonary hypertensive subjects with normal left ventricular function.
Background The aim of study was to assess whether a specific morphology of the right ventricle ( RV) by 2D echo predicts the hemodynamic nature of pulmonary hypertension ( PH). Methods We reviewed clinical, 2D echo, and hemodynamic data of 100 patients with PH: divided into three groups: PH from pul...
| Publicado en: | Echocardiography Vol. 34; no. 11; pp. 1584 - 1593 |
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| Autores principales: | , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Nov2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=126407762&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 126407762 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Nov2017 vid: 34 iid: 11 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 126407762 126407762 126407762 10.1111/echo.13699 126407762 ppf: 1584 ppct: 9 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Differences in right ventricular morphology, not function, indicate the nature of increased afterload in pulmonary hypertensive subjects with normal left ventricular function. aug: au: Raza, Farhan Dillane, Catherine Mirza, Arslan Brailovsky, Yevgeniy Weaver, Sheila Keane, Martin G. Forfia, Paul affil: Heart and Vascular Institute, Temple University Hospital, Philadelphia PA, USA sug: subj: Heart Ventricle, Right Hypertension, Pulmonary Heart Ventricle, Left Human Hemodynamics Heart Function Tests ROC Curve Systolic Pressure ab: Background The aim of study was to assess whether a specific morphology of the right ventricle ( RV) by 2D echo predicts the hemodynamic nature of pulmonary hypertension ( PH). Methods We reviewed clinical, 2D echo, and hemodynamic data of 100 patients with PH: divided into three groups: PH from pulmonary vascular disease ( PHPVD; n = 34) with pulmonary vascular resistance ( PVR) > 3 mm Hg/L/min ( Wood unit [WU]) and pulmonary artery wedge pressure ( PAWP) ≤ 15 mm Hg, pulmonary venous hypertension ( PVH; n = 33) with PVR < 3 WU and PAWP > 15 mm Hg and PHMIXED (n = 33) with PVR > 3 WU and PAWP > 15 mm Hg. We analyzed several two-dimensional parameters of right heart morphology and function, including the degree of tapering of the RV diameter from base (just above tricuspid annulus) to apex (level of moderator band) in the apical four-chamber view. P = <.05. Results Baseline characteristics were similar in all three groups: age 62 ± 14.4 years, 69% females, 57% Caucasians. Hemodynamics and 2D echo data of PHPVD vs PVH vs PHMIXED were as follows: PVR 13 ± 6 vs 2 ± 1 vs 7 ± 2 WU, mean pulmonary artery pressure 53 ± 14 vs 34 ± 8 vs 49 ± 8 mm Hg and cardiac index 2.0 ± 0.5 vs 2.8 ± 0.7 vs 2.2 ± 0.7 L/m2, RV base/apex ratio during systole ( sRVb/a) 1.3 ± 0.2 vs 2.6 ± 0.5 vs 1.5 ± 0.3. Thus, sRVb/a was twofold higher in the PVH vs PHPVD cohort. On ROC analysis, the AUC for sRVb/a for predicting PVR > 3 WU was 0.873, with optimal cutoff of 1.5. Conclusion Systolic RV base/apex ratio is a simple 2D index of RV shape that powerfully predicts a PVR > 3 WU and provides powerful discriminating ability between PVH and PHPVD. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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