Right ventricular outflow tract velocity time integral (RVOT VTI) and tricuspid regurgitation velocity/RVOT VTI ratio in pediatric pulmonary hypertension

2016 ◽  
Vol 212 ◽  
pp. 274-276 ◽  
Author(s):  
Martin Koestenberger ◽  
Alexander Avian ◽  
Gernot Grangl ◽  
Ante Burmas ◽  
Stefan Kurath-Koller ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Tricuspid Regurgitation ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Velocity Time Integral ◽  
Time Integral

scholarly journals Right Ventricular Outflow Doppler Predicts Low Cardiac Index in Intermediate Risk Pulmonary Embolism

2019 ◽  
Vol 25 ◽  
pp. 107602961988606 ◽  
Author(s):  
Yevgeniy Brailovsky ◽  
Vladimir Lakhter ◽  
Ido Weinberg ◽  
Katerina Porcaro ◽  
Jeremiah Haines ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Index ◽  
Right Ventricular ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Intermediate Risk ◽  
Velocity Time Integral ◽  
Time Integral ◽  
Related Mortality

Intermediate-risk pulmonary embolism (PE) has variable outcomes. Current risk stratification models lack the positive predictive value to identify patients at highest risk of PE-related mortality. We identified intermediate-risk PE patients who underwent catheter-based interventions and right heart catheterization (RHC) and identified those with low cardiac index (CI < 2.2 L/min/m2). We utilized regression models to identify echocardiographic predictors of low CI and Kaplan Meier curve to evaluate PE-related mortality when stratified by the echocardiographic predictor. Of 174 intermediate-risk PE patients, 41 underwent RHC. Within this cohort, 46.3% had low CI. Univariable linear regression identified right ventricular outflow tract velocity time integral (RVOT VTI), right/left ventricular ratio, S prime, inferior vena cava diameter, and pulmonary artery systolic pressure as potential predictors of low CI. Multivariable linear regression identified RVOT VTI as significant predictor of low CI (β coefficient 0.124, 95% confidence interval [CI]: 0.01-0.24, P = .034). Right ventricular outflow tract velocity time integral <9.5 cm was associated with increased PE-related mortality, P = .002. A substantial proportion of intermediate-risk PE patients referred for catheter-based interventions had low CI despite normotension. Right ventricular outflow tract velocity time integral was a significant predictor of low CI. Low RVOT VTI was associated with increased PE-related mortality.

Development of right ventricular outflow tract obstruction after double-lung transplantation for primary pulmonary hypertension

1995 ◽  
Vol 5 (3) ◽  
pp. 278-281 ◽  
Author(s):  
Gül Sagin Saylam ◽  
Jane Somerville
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Transplantation ◽  
Right Ventricular ◽  
Primary Pulmonary Hypertension ◽  
Pulmonary Arterial Pressure ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Outflow Tract ◽  
Pulmonary Arterial ◽  
The Right

SummaryWe present a patient with primary pulmonary hypertension who had unusually high pulmonary arterial pressure prior to double-lung transplantation. Obstruction of the right ventricular outflow tract developed after transplantation and progressed over the subsequent two years.

scholarly journals Relationship of left ventricular outflow tract velocity time integral to treatment strategy in submassive and massive pulmonary embolism

2020 ◽  
Vol 10 (3) ◽  
pp. 204589402095372
Author(s):  
David Antoine ◽  
Taylor Chuich ◽  
Ruben Mylvaganam ◽  
Chris Malaisrie ◽  
Benjamin Freed ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Left Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Outflow Tract ◽  
Velocity Time Integral ◽  
Systemic Thrombolysis ◽  
Percent Change ◽  
Time Integral ◽  
Left Ventricular Outflow

Pulmonary embolism is associated with high rates of mortality and morbidity. It is important to understand direct comparisons of current interventions to differentiate favorable outcomes and complications. The objective of this study was to compare ultrasound-accelerated thrombolysis versus systemic thrombolysis versus anticoagulation alone and their effect on left ventricular outflow tract velocity time integral. This was a retrospective cohort study of subjects ≥18 years of age with a diagnosis of submassive or massive pulmonary embolism. The primary outcome was the percent change in left ventricular outflow tract velocity time integral between pre- and post-treatment echocardiograms. Ultrasound-accelerated thrombolysis compared to anticoagulation had a greater improvement in left ventricular outflow tract velocity time integral, measured by percent change. No significant change was noted between the ultrasound-accelerated thrombolysis and systemic thrombolysis nor systemic thrombolysis and anticoagulation groups. Pulmonary artery systolic pressure only showed a significant reduction in the ultrasound-accelerated thrombolysis versus anticoagulation group. The percent change of right ventricular to left ventricular ratios was improved when systemic thrombolysis was compared to both ultrasound-accelerated thrombolysis and anticoagulation. In this retrospective study of submassive or massive pulmonary embolisms, left ventricular outflow tract velocity time integral demonstrated greater improvement in patients treated with ultrasound-accelerated thrombolysis as compared to anticoagulation alone, a finding not seen with systemic thrombolysis. While this improvement in left ventricular outflow tract velocity time integral parallels the trend seen in mortality outcomes across the three groups, it only correlates with changes seen in pulmonary artery systolic pressure, not in other markers of echocardiographic right ventricular dysfunction (tricuspid annular plane systolic excursion and right ventricular to left ventricular ratios). Changes in left ventricular outflow tract velocity time integral, rather than echocardiographic markers of right ventricular dysfunction, may be considered a more useful prognostic marker of both dysfunction and improvement after reperfusion therapy.

scholarly journals Right ventricular outflow tract velocity time integral-to-pulmonary artery systolic pressure ratio: a non-invasive metric of pulmonary arterial compliance differs across the spectrum of pulmonary hypertension

2019 ◽  
Vol 9 (2) ◽  
pp. 204589401984197 ◽  
Author(s):  
Priyanka T. Bhattacharya ◽  
Gregory S. Troutman ◽  
Frances Mao ◽  
Arieh L. Fox ◽  
Monique S. Tanna ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Functional Capacity ◽  
Arterial Compliance ◽  
Systolic Pressure ◽  
Outflow Tract ◽  
Velocity Time Integral ◽  
Non Invasive ◽  
Time Integral ◽  
Pulmonary Arterial

Pulmonary arterial compliance (PAC), invasively assessed by the ratio of stroke volume to pulmonary arterial (PA) pulse pressure, is a sensitive marker of right ventricular (RV)-PA coupling that differs across the spectrum of pulmonary hypertension (PH) and is predictive of outcomes. We assessed whether the echocardiographically derived ratio of RV outflow tract velocity time integral to PA systolic pressure (RVOT-VTI/PASP) (a) correlates with invasive PAC, (b) discriminates heart failure with preserved ejection-associated PH (HFpEF-PH) from pulmonary arterial hypertension (PAH), and (c) is associated with functional capacity. We performed a retrospective cohort study of patients with PAH (n = 70) and HFpEF-PH (n = 86), which was further dichotomized by diastolic pressure gradient (DPG) into isolated post-capillary PH (DPG < 7 mmHg; Ipc-PH, n = 54), and combined post- and pre-capillary PH (DPG ≥ 7 mm Hg; Cpc-PH, n = 32). Of the 156 patients, 146 had measurable RVOT-VTI or PASP and were included in further analysis. RVOT-VTI/PASP correlated with invasive PAC overall (ρ = 0.61, P < 0.001) and for the PAH (ρ = 0.38, P = 0.002) and HFpEF-PH (ρ = 0.63, P < 0.001) groups individually. RVOT-VTI/PASP differed significantly across the PH spectrum (PAH: 0.13 [0.010–0.25] vs. Cpc-PH: 0.20 [0.12–0.25] vs. Ipc-PH: 0.35 [0.22–0.44]; P < 0.001), distinguished HFpEF-PH from PAH (AUC = 0.72, 95% CI = 0.63–0.81) and Cpc-PH from Ipc-PH (AUC = 0.78, 95% CI = 0.68–0.88), and remained independently predictive of 6-min walk distance after multivariate analysis (standardized β-coefficient = 27.7, 95% CI = 9.2–46.3; P = 0.004). Echocardiographic RVOT-VTI/PASP is a novel non-invasive metric of PAC that differs across the spectrum of PH. It distinguishes the degree of pre-capillary disease within HFpEF-PH and is predictive of functional capacity.

Sign in / Sign up

Export Citation Format

Share Document