Right ventricular morphology and function analysis in moderately preterm-born young adults

Abstract Background Previous studies have shown that prematurity leads to altered right ventricular (RV) geometry and performance with persistent impairments in RV systolic function in young adulthood. It is unknown to what extent pulmonary physiology impacts these findings. Purpose To better quantify known alterations in RV morphology and function in preterm-born young adults and to determine to what extent these changes are influenced by the pulmonary circulation. Methods A total of 101 normotensive preterm-born (n=47, mean gestational age 32.8±3.2 weeks) and term-born (n=54) young adults were recruited. Echocardiography and cardiovascular magnetic resonance (CMR) imaging were performed to characterise RV morphology, RV function, pulmonary hemodynamics and RV-pulmonary arterial vascular (PA) coupling. CMR cine images were used to create a 3D computational atlas of the RV geometry and principal component analysis was undertaken to identify the key modes of shape variation. Spirometry was performed to assess lung function. Results RV CMR revealed a higher absolute and indexed RV mass (P<0.05) and lower ejection fraction (54.90±5.17 versus 57.48±4.39%, P=0.008) in young adults born preterm. RV end-diastolic areas and volumes for CMR and echocardiography were lower in preterm-born compared to term-born young adults (P≤0.001). Principal component analysis of the computational atlas defined the anatomical modes of the RV geometry, with mode 1 accounting for 25.3% of the population variance. Preterm and term cohorts showed significant differences (P<0.001) in mode 1, which represented a smaller and shorter RV cavity in the preterm group (Figure 1). Measurements of RV function by echocardiography, including RV fractional area of change (FAC) and tricuspid annular plane systolic excursion (TAPSE), were lower in preterm-born compared to term-born adults (P<0.05). Despite lower pulmonary artery acceleration times (PAAT) in those born preterm (141.1±15.1 versus 159.2±21.6msec, P<0.001), indicating increased pulmonary vascular resistance, the RV remained coupled to its pulmonary circulation (TAPSE/PAAT: 0.13±0.02 versus 0.14±0.03m/sec, P=0.153). Reduced RV performance in preterm-born individuals remained significant when adjusting for pulmonary function parameters (P<0.05). Conclusions Multimodality cardiac imaging demonstrated that moderately preterm-born young adults exhibit structural and functional RV alterations, independent of lung physiology. Their RV remains hemodynamically coupled to its pulmonary circulation despite higher RV afterload, lower RV function and altered morphology. Figure 1. Statistical shape model of the RV Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): British Heart Foundation

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Right ventricular morphology and function undergo complex changes after cardiac surgery

European Heart Journal ◽

10.1093/ehjci/ehaa946.0046 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

P Wejner-Mik ◽

J.D Kasprzak ◽

E Szymczyk ◽

K Wdowiak-Okrojek ◽

A Ammer ◽

...

Keyword(s):

Cardiac Surgery ◽

Right Ventricular ◽

Artery Bypass ◽

Public Institution ◽

Transverse Diameter ◽

Funding Source ◽

Longitudinal Function ◽

Echocardiographic Examination ◽

And Function ◽

Rv Function

Abstract Background An impairment of certain echocardiographic parameters of right ventricular (RV) function, such as tricuspid annular peak systolic excursion (TAPSE), is a known phenomenon in patients undergoing cardiac surgery. However, little is known about significance of these alterations with regard to other aspects of RV function. The aim of our study was to clarify this issue using parameters based on 3D echocardiography and speckle tracking technique. Methods The study population comprised 122 patients (92 men, mean age 65±11 years), referred for coronary artery bypass grafting and/or replacement of mitral or aortic valve. Patients undergoing tricuspid annuloplasty and with baseline suboptimal image quality were excluded from the study group. Transthoracic echocardiographic examination was performed on average 2±2 days prior to surgery (TTE1), and 7±4 days after surgery (TTE2), whereas follow-up TTE (TTE3) was performed on average 12±2months after the surgery. Parameters measured during these examinations included both standard and advanced indices of RV size and function (such as TAPSE, systolic velocity of tricuspid annulus (S'), fractional area change (FAC), RV ejection fraction (EF) and RV global longitudinal systolic strain (GLS), as well as a new parameter introduced by our team - RV shortening fraction (RV SF), calculated as the change in mid RV transverse diameter. Results Echocardiographic measurements were completed for TTE1, TTE2 and TTE3 in 95% of patients. We noticed a significant postoperative (TTE2) impairment of parameters of RV longitudinal function (TAPSE, S' and GLS; p<0,0001). However, neither RV size assessed by both 2D and 3D technique changed, nor the global RV function measured with the use of FAC and EF. Additionally during the postoperative period an increase in the value of a RV SF by 12.85% was observed. After 12 months (TTE3) we observed an improvement in the parameters of the longitudinal RV function. Conclusion Cardiac surgery results in an impairment of the longitudinal systolic RV function, with no influence on the global RV function. The preservation of global function results from increased RV SF. After 12 months, an improvement of the longitudinal function can be observed. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Grant Polish Cardiac Society

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Right Ventricular Structure and Function in Young Adults Born Preterm at Very Low Birth Weight

Journal of Clinical Medicine ◽

10.3390/jcm10214864 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4864

Author(s):

Charlotte Greer ◽

Sarah L. Harris ◽

Richard Troughton ◽

Philip D. Adamson ◽

John Horwood ◽

...

Keyword(s):

Young Adults ◽

Birth Weight ◽

Low Birth Weight ◽

Right Ventricular ◽

Very Low Birth Weight ◽

Left Ventricular ◽

Normal Weight ◽

Structure And Function ◽

And Function ◽

Rv Function

Being born preterm (PT, <37 weeks gestation) or at very low birth weight (VLBW, <1500 g) is associated with increased rates of cardiopulmonary disorders in childhood. As survivors age, late cardiac effects, including right ventricular (RV) remodelling and occult pulmonary hypertension are emerging. In this population-based study, we aimed to investigate right heart structure and function in young adults born PT at VLBW compared to normal-weight term-born controls. The New Zealand VLBW Study has followed all infants born in 1986 with birth weight <1500 g. All were born preterm from 24 to 37 weeks. A total of 229 (71% of survivors) had echocardiograms aged 26–30 years which were compared to age-matched, term-born, normal-weight controls (n = 100). Young adults born preterm at very low birth weight exhibited smaller RV dimensions compared to term-born peers. Standard echocardiographic measures of RV function did not differ, but mildly reduced function was detected by RV longitudinal strain. This difference was related to birth weight and gestational age but not lung function or left ventricular function. Echocardiographic strain imaging may be an important tool to detect differences in RV function preterm and VLBW.

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Sildenafil Administration Improves Right Ventricular Function on 4D Flow MRI in Young Adults Born Premature

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00824.2020 ◽

2021 ◽

Author(s):

Philip A Corrado ◽

Gregory P Barton ◽

Christopher J François ◽

Oliver Wieben ◽

Kara N Goss

Keyword(s):

Heart Rate ◽

Young Adults ◽

Kinetic Energy ◽

Right Ventricular ◽

Right Atrial ◽

4D Flow Mri ◽

4D Flow ◽

Direct Flow ◽

Flow Mri ◽

Rv Function

Background: Extreme preterm birth conveys an elevated risk of heart failure by young adulthood. Smaller biventricular chamber size, diastolic dysfunction, and pulmonary hypertension may contribute to reduced ventricular-vascular coupling. However, how hemodynamic manipulations may affect right ventricular (RV) function and coupling remains unknown. Methods: As a pilot study, 4D flow MRI was used to assess the effect of afterload reduction and heart rate reduction on cardiac hemodynamics and function. Young adults born premature were administered sildenafil (a pulmonary vasodilator) and metoprolol (a beta blocker) on separate days, and MRI with 4D flow completed before and after each drug administration. Endpoints include cardiac index (CI), direct flow fractions, and ventricular kinetic energy including E/A wave kinetic energy ratio. Results: Sildenafil resulted in a median CI increase of 0.24 L/min/m2 (P=0.02), mediated through both an increase in heart rate (HR) and stroke volume. Although RV ejection fraction improved only modestly, there was a significant increase (4% of end diastolic volume) in RV direct flow fraction (P=0.04), consistent with hemodynamic improvement. Metoprolol administration resulted in a 5-bpm median decrease in HR (P=0.01), a 0.37 L/min/m2 median decrease in CI (P=0.04), and a reduction in time-averaged kinetic energy (KE) in both ventricles (P<0.01), despite increased RV diastolic E/A KE ratio (P=0.04). Conclusions: Despite reduced right atrial workload, metoprolol significantly depressed overall cardiac systolic function. Sildenafil, however, increased CI and improved RV function, as quantified by the direct flow fraction. The preterm heart appears dependent on HR, but sensitive to RV afterload manipulations.

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Fibre attributes and mapping the cultivar influence of different industrial cellulosic crops (cotton, hemp, flax, and canola) on textile properties

Bioresources and Bioprocessing ◽

10.1186/s40643-020-00339-1 ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

Ikra Iftekhar Shuvo

Keyword(s):

Principal Component Analysis ◽

Statistical Analysis ◽

Principal Component ◽

Textile Fibre ◽

Two Dimensional ◽

Production Engineering ◽

Hemp Fibres ◽

Likelihood Analysis ◽

Microscopic Studies ◽

And Function

Abstract Natural lignocellulosic fibres (NLF) extracted from different industrial crops (like cotton, hemp, flax, and canola) have taken a growing share of the overall global use of natural fibres required for manufacturing consumer apparels and textile substrate. The attributes of these constituent NLF determine the end product (textiles) performance and function. Structural and microscopic studies have highlighted the key behaviors of these NLF and understanding these behaviors is essential to regulate their industrial production, engineering applications, and harness their benefits. Breakthrough scientific successes have demonstrated textile fibre properties and significantly different mechanical and structural behavioral patterns related to different cultivars of NLF, but a broader agenda is needed to study these behaviors. Influence of key fibre attributes of NLF and properties of different cultivars on the performance of textiles are defined in this review. A likelihood analysis using scattergram and Pearson’s correlation followed by a two-dimensional principal component analysis (PCA) to single-out key properties explain the variations and investigate the probabilities of any cluster of similar fibre profiles. Finally, a Weibull distribution determined probabilistic breaking tenacities of different fibres after statistical analysis of more than 60 (N > 60) cultivars of cotton, canola, flax, and hemp fibres.

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Evaluation Study on the Network Impact Index of WeChat Based on Principal Component Analysis

Journal of Computational and Theoretical Nanoscience ◽

10.1166/jctn.2016.6085 ◽

2016 ◽

Vol 13 (10) ◽

pp. 7676-7679 ◽

Cited By ~ 1

Author(s):

Yi Liu

Keyword(s):

Principal Component Analysis ◽

Principal Components ◽

Influence Factors ◽

Principal Component ◽

Modern Society ◽

Component Analysis ◽

Evaluation Study ◽

Positive Energy ◽

Impact Index ◽

And Function

WeChat software is an important social tool in modern society. This paper discusses the network impact of WeChat from ten aspects including WeChat popularity, attention, video observability, network reputation, function usability, dissemination speed of information, transmission ratio of positive energy and impact of WeChat on network economy, politics and culture, and questionnaires on these ten influence factors are distributed to college students for investigation. Principal component analysis is used to deal with the survey results, the principal components of the ten factors are extracted, and the results show that WeChat popularity, attention, video observability, network reputation and function usability are the main components, in which WeChat popularity, attention and video observability are the factors having the greatest impact on the calculation. And this paper presents the function relationship between the main principal components of WeChat network impact index and these ten influence factors, to evaluate the network impact index of WeChat.

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P1413 Complexity of changes in right ventricular function in patients undergoing cardiac surgery

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.846 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

P Wejner-Mik ◽

J D Kasprzak ◽

E Szymczyk ◽

K Wdowiak-Okrojek ◽

A Ammer ◽

...

Keyword(s):

Cardiac Surgery ◽

Right Ventricular ◽

Artery Bypass ◽

Longitudinal Function ◽

Echocardiographic Examination ◽

Echocardiographic Parameters ◽

Study Population ◽

And Function ◽

2D And 3D ◽

Rv Function

Abstract Background An impairment of certain echocardiographic parameters of right ventricular (RV) function, such as tricuspid annular peak systolic excursion (TAPSE), is a known phenomenon in patients undergoing cardiac surgery. However, little is known about significance of these alterations with regard to other aspects of RV function. The aim of our study was to clarify this issue using parameters based on 3D echocardiography and speckle tracking technique. Methods The study population comprised 105 patients (76 men, mean age 65 ± 16 years), referred for coronary artery bypass grafting and/or replacement of mitral or aortic valve. Patients undergoing tricuspid annuloplasty and with baseline suboptimal image quality were excluded from the study group. Transthoracic echocardiographic examination was performed on average 2 ± 2 days prior to surgery (TTE1) , and 7 ± 4 days after surgery (TTE2), whereas follow-up TTE (TTE3) was performed on average 12 ± 2months after the surgery. Parameters measured during these examinations included both standard and advanced indices of RV size and function, such as TAPSE, systolic velocity of tricuspid annulus (S"), fractional area change (FAC), RV ejection fraction (EF) and RV global longitudinal systolic strain (GLS). Results Echocardiographic measurements were completed for TTE1, TTE2 and TTE3 in 95% of patients. We noticed a significant postoperative (TTE2) impairment of parameters of RV longitudinal function (TAPSE, S’ and GLS; p < 0,0001). However, neither RV size assessed by both 2D and 3D technique changed, nor the global RV function measured with the use of FAC and EF. After 12 months (TTE3) we observed an improvement in the parameters of the longitudinal RV function. Conclusion Cardiac surgery results in an impairment of the longitudinal systolic RV function, with no influence on the global RV function. After 12 months, an improvement of the longitudinal function can be observed.

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Validation of the Edinburgh Postnatal Depression Scale for Use With Young Childbearing Women

Journal of Nursing Measurement ◽

10.1891/1061-3749.25.1.1 ◽

2017 ◽

Vol 25 (1) ◽

pp. 1E-16E

Author(s):

Kira Friesen ◽

Wendy E. Peterson ◽

Janet Squires ◽

Cathryn Fortier

Keyword(s):

Principal Component Analysis ◽

Young Adults ◽

Young Women ◽

Test Scores ◽

Postnatal Depression ◽

Edinburgh Postnatal Depression Scale ◽

Perinatal Depression ◽

Depression Scale ◽

Principal Component ◽

Childbearing Women

Background and Purpose: The Edinburgh Postnatal Depression Scale (EPDS) was created specifically to screen for perinatal depression. The purpose of this study was to assess the psychometric properties of the EPDS for use in a population of pregnant and postpartum 14- to 24-year-olds in Canada. Methods: The Standards for Educational and Psychological Testing was used as the psychometric framework to assess the validity, reliability, and acceptability of responses obtained using the EPDS with pregnant and postpartum adolescents and young adults. Results: There were 102 young women who were surveyed. Principal component analysis supported the EPDS as a 2-dimensional instrument. Test scores also showed the EPDS to be reliable and acceptable. Conclusions: The EPDS was found to be a psychometrically sound tool for use in this population of young childbearing women.

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Right ventricular pulmonary vascular coupling in secondary tricuspid regurgitation: a pressure volume loop study

European Heart Journal ◽

10.1093/ehjci/ehaa946.1903 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Schmeisser ◽

T Rauwolf ◽

T Groscheck ◽

I Tanev ◽

M Hansen ◽

...

Keyword(s):

Right Ventricular ◽

Tricuspid Regurgitation ◽

Binary Logistic Regression Analysis ◽

Funding Source ◽

Coupling Ratio ◽

Private Company ◽

Left Heart Failure ◽

Pronounced Increase ◽

Catheter Technique ◽

Rv Function

Abstract Introduction The severity of secondary tricuspid regurgitation (sTR) predicts outcome of patients with left heart failure with reduced ejection fraction (HFrEF). In these patients sTR predominantly occurs as a result of secondary pulmonary hypertension (PH). However, more than 46% of patients with severe PH have only mild or none sTR. In this study we tested the hypothesis that intrinsic right ventricular (RV) contractility adaptation to the pulmonary arterial (PA) vascular load (RV-PA-coupling) is associated with the presence and severity of sTR. Methods In 110 patients with HFrEF (a post-hoc analysis of the Magdeburger CRT Responder Trial, DRKS00011133) we quantified the RV intrinsic contractility response (end-systolic elastance, Ees) to pulmonary vascular afterload (arterial elastance, Ea) and its coupling ratio (RV-PA coupling ratio: Ees/Ea) by the RV pressure-volume loop catheter technique at baseline, and combined it with echocardiography-derived parameter of sTR presence and severity and RV function. Results Echocardiography at baseline demonstrated no or trace TR (TR0) in 67 patients (61%), mild TR (TR1) in 23 (21%), moderate TR (TR2) in 11 (10%), and severe TR (TR3) in 9 (8%). The transition from TR0 to TR1 was characterized by a pronounced drop of the RV-PA coupling ratio (TR0: Ees/Ea= 0.88, 0.67–1.1 vs. TR1: Ees/Ea= 0.48, 0.3–0.83, p<0.001), caused by a non-adaptive, non-rising Ees (0.24 mmHg/ml, 0.34–0.44 vs. 0.3 mmHg/ml, 0.21–0.46, p=0.8, respectively, p<0.001). We observed a further but only marginal drop of Ees/Ea from TR1 to TR3 (p=0.008) caused by an additional small non-significant decrease of Ees and increase of Ea. Interestingly, other afterload parameter, such as PA-pressure, wedge pressure (PCWP), PA compliance, and PA resistance (PVR), and parameters of RV function, such as tricuspid annular plane systolic excursion (TAPSE) and fractional area shortening (FAC) followed the same course of a pronounced drop from TR0 to TR1, succeeded by an only marginal change from TR1 to TR3. In contrast, the progressive RV-PA un-coupling from TR0 to TR3 was accompanied by a more or less continuously increase of RV size and volume load (end-diastolic (ED) area in 4 chamber view, ED-RV outflow tract diameter, size of tricuspid annulus). In the binary logistic regression analysis, the decrease of RV-PA coupling ratio Ees/Ea (OR 0.14, CI 0.001–0.165) and PA compliance (OR 0.44, CI 0.25–0.79) were independently associated with the transition from TR0 to TR1–3. Conclusion The presence and severity of secondary TR in patients with HFREF is independently associated with a progressive RV-PA uncoupling. Most importantly, already the transition from none TR to mild TR is characterized by a significant and pronounced increase of pulmonary vascular afterload, a non-adaptive RV contractility response, and resulting RV-PA un-coupling. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Boston Scientific

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Transthoracic Echocardiography in Children and Young Adults with Congenital Heart Disease

ISRN Pediatrics ◽

10.5402/2012/753481 ◽

2012 ◽

Vol 2012 ◽

pp. 1-15 ◽

Cited By ~ 18

Author(s):

Martin Koestenberger

Keyword(s):

Congenital Heart Disease ◽

Young Adults ◽

Heart Disease ◽

Right Ventricular ◽

Transthoracic Echocardiography ◽

Congenital Heart ◽

Doppler Imaging ◽

Ventricular Performance ◽

Children And Young Adults ◽

Rv Function

Transthoracic echocardiography (TTE) is the first-line tool for diagnosis and followup of pediatric and young adult patients with congenital heart disease (CHD). Appropriate use of TTE can reduce the need for more invasive modalities, such as cardiac catheterization and cardiac magnetic resonance imaging. New echocardiographic techniques have emerged more recently: tissue Doppler imaging, tissue tracking (strain and strain rate), vector velocity imaging (VVI), myocardial performance index, myocardial acceleration during isovolumic acceleration (IVA), the ratio of systolic to diastolic duration (S/D ratio), and two dimensional measurements of systolic right ventricular (RV) function (e.g., tricuspid annular plane systolic excursion, TAPSE). These may become valuable indicators of ventricular performance, compliance, and disease progression. In addition, three-dimensional (3D) echocardiography when performed for the assessment of valvular function, device position, and ventricular volumes is being integrated into routine clinical care. In this paper, the potential use and limitations of these new echocardiographic techniques in patients with CHD are discussed. A particular focus is on the echocardiographic assessment of right ventricular (RV) function in conditions associated with increased right ventricular volume (e.g., pulmonary regurgitation after tetralogy of Fallot repair) or pressure (e.g., pulmonary hypertension) in children and young adults.

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