P1493Prognostic significance of right ventricular function during exercise in patients with non-obstructive hypertrophic cardiomyopathy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Hirasawa ◽  
M Izumo ◽  
K Mizukoshi ◽  
T Suzuki ◽  
Y Sato ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Risk Stratification ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Cardiac Death ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Life Threatening ◽  
Rv Function

Abstract Background Hypertrophic cardiomyopathy (HCM) is a heterogeneous condition that may present crucial complication including life-threatening arrhythmia and sudden cardiac death. However, the risk stratification of HCM without left ventricular outflow tract (LVOT) obstruction had not been fully elucidated. Moreover, although recent studies have revealed the right ventricle (RV) involvement of HCM, the prognostic importance of RV function during exercise is unclear. Purpose To investigate the prognostic significance of RV function in patients with non-obstructive HCM using exercise stress echocardiography (ESE). Methods and results This study conducted on 100 HCM patients (age 62.9±13.6 years, 63% men) with preserved left ventricular ejection fraction who underwent ESE using semi-supine bicycle ergometer. Ten patients with significant LVOT obstruction (≥30mmHg) were excluded and 9 were also excluded because of the inadequate imaging quality or insufficiency of data. Among remaining 81 non-obstructive HCM patients, 9 patients suffered from HCM related cardiac events including cardiac death, unexpected hospitalization, life-threatening arrhythmias, and new-onset of syncope during the mean follow up period of 2.6±1.6 years. A multivariate Cox Hazard analysis revealed that low tricuspid annular plane systolic excursion during exercise (Ex-TAPSE, cut-off: 24mm) was an independent predictor of cardiac events. (hazard ratio: 18.66, 95% confidence interval: 3.66–338.46, P<0.001) The estimated cumulative cardiac event free survival using the Kaplan-Meier method was significantly lower in patients with reduced Ex-TAPSE (<24mm) than those with preserved Ex-TAPSE (Log-rank, P<0.01). K-M curve according to Ex-TAPSE Conclusion Ex-TAPSE had a strong predictive value of clinical outcomes in non-obstructive HCM patients. Right ventricular function during exercise may have crucial role in the risk stratification of non-obstructive HCM.

scholarly journals Echocardiographic Evaluation of Right Ventricular Function in the Immediate Postoperative Period after Major Pulmonary Resections: A Prospective Observational Study

2017 ◽  
Vol 5 (2) ◽  
pp. 42-48
Author(s):  
Banashree Mandal ◽  
Vikas Dutta ◽  
Balbir Kumar ◽  
Alok Kumar ◽  
Rajarajan Ganesan ◽  
...  
Keyword(s):  
Observational Study ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Postoperative Period ◽  
Right Ventricular Function ◽  
Prospective Observational Study ◽  
Left Ventricular ◽  
Echocardiographic Evaluation ◽  
Echocardiographic Parameters ◽  
Rv Function

ABSTRACT Aim We aimed to identify the impact through the use of standard and novel echocardiographic parameters, i.e., speckle tracking echocardiography (STE) to evaluate the right and left ventricular (LV) myocardial function in patients who underwent lung resections. Materials and methods We identified patients that underwent lobectomy or pneumonectomy at our institution in 2016 to 2017. We performed preoperative transthoracic echocardiography (TTE) in each patient and on postoperative days (PODs) 2, 7, and 30 when available. Results Of a total of 26 patients included in the study, 5 underwent pneumonectomy, while the rest underwent lobectomy. Left and right pneumonectomy was performed in 38 and 62% of the patients respectively. None of the patients had right ventricular (RV) dilation or dysfunction on preoperative echocardiograms. Postoperatively, mean LV ejection fraction (LVEF) was 52 (±7.5) %. Mean RV strain in immediate postoperative period (day 2) was –15.1% (reduction of more than 20%). None of the patients progressed to RV failure or had mortality. Estimated RV systolic pressure was 41 (±20) mm Hg. The differences in RV echocardiographic parameters were significantly different pre- and postsurgery. The RV function decreased significantly on POD 2, which improved slightly thereafter. Extent of resection and side of resection did not make a difference in the RV functions. Conclusion After lung resection, patients developed deterioration in RV function that may be reflected by any of the echocardiographic parameters used to assess RV function. Deterioration in RV function is maximum in the immediate postoperative period (day 2), which improves to preoperative level by 4 weeks. How to cite this article Bhat IH, Kumar A, Kumar B, Ganesan R, Mandal B, Dutta V. Echocardiographic Evaluation of Right Ventricular Function in the Immediate Postoperative Period after Major Pulmonary Resections: A Prospective Observational Study. J Perioper Echocardiogr 2017;5(2):42-48.

scholarly journals Assessment of right ventricular function during exercise echocardiography in adult patients with tetralogy of Fallot

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Peteiro ◽  
M Rivadulla-Varela ◽  
B Bouzas-Zubeldia ◽  
I Martinez-Bendayan ◽  
A Bouzas-Mosquera ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Tetralogy Of Fallot ◽  
Functional Capacity ◽  
Left Ventricular ◽  
Exercise Echocardiography ◽  
Tricuspid Annulus ◽  
Area Change ◽  
Metabolic Equivalents ◽  
Rv Function

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The evaluation of right ventricular (RV) function in patients with  tetralogy of Fallot (TF)  is important as it could impact outcome. Further exhaustive assessments with exercise might offer added information. We aimed to evaluate different parameters of RV function and their changes during exercise echocardiography (ExE) in patients with TF, and to correlate them with functional capacity Methods Treadmill ExE was performed in 31 consecutive patients with corrected TF (mean age 36 ± 11, 22 male), all of them asymptomatic. Left ventricular function was studied at peak exercise, whereas RV function parameters were acquired during the immediate post-exercise period (&lt;1.5 min), along with mitral, tricuspid and pulmonary regurgitation (PR), transtricuspid and transpulmonary systolic gradients, and LV-E/e´ values. RV function was assessed by tricuspid annulus plane systolic excursion (TAPSE), S wave velocity in the RV lateral annulus, and RV area change. A blunted functional capacity (BFC) was considered in case of achieving &lt;100% of the predicted metabolic equivalents (METs) during ExE, according to age and gender. Results Only 1 patient had symptoms during ExE (dyspnea). Achieved METs were 13 ± 3.5 and 10 patients (32%) had BFC. LV ejection fraction (%) changed with exercise from 58 ± 10 to 63 ± 9 (p = 0.05) and E/e´ from 11 ± 4 to 10 ± 3 (p = 0.04). TAPSE did not change (19 ± 5 at rest; 21 ± 7 at exercise; p = NS), neither RV area change (41 ± 11 cm2 at rest; 39 ± 12 cm2 at exercise; p = NS), whereas TDI-S increased from 10.5 ± 2.8 to 13.8 ± 3.1 cm2/s (p &lt; 0.001), and systolic pulmonary pressure from 20 ± 8 to 27 ± 12 mmHg (p = 0.001). Patients with BFC had more frequently significant PR at rest (60% vs 14%; p = 0.015), lower peak systolic blood pressure (152 ± 30 vs 176 ± 24 mmHg, p = 0.02) and higher exercise E/e´ (12.6 ± 2.7 vs 8.9 ± 3.0; p = 0.003), without differ in other parameters. Δ-TDI-S correlated with achieved METs and with the percent achieved of predicted METs (r = 0.46; p = 0.01, y r = 0.47; p = 0.008, respectively). In conclusion, TDI-S assessment at the tricuspid annulus is a useful parameter for assessing RV function during exercise in subjects with TF. Abstract Figure.

scholarly journals Prognostic Value of Echocardiographic Right Ventricular Function Parameters in the Presence of Severe Tricuspid Regurgitation

2021 ◽  
Vol 10 (11) ◽  
pp. 2266
Author(s):  
Matthias Schneider ◽  
Varius Dannenberg ◽  
Andreas König ◽  
Welf Geller ◽  
Thomas Binder ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Tricuspid Regurgitation ◽  
Right Ventricular Function ◽  
Prognostic Value ◽  
Large Scale ◽  
Systolic Function ◽  
Left Ventricular ◽  
Severe Tricuspid Regurgitation ◽  
Vena Contracta

Background: Presence of severe tricuspid regurgitation (TR) has a significant impact on assessment of right ventricular function (RVF) in transthoracic echocardiography (TTE). High trans-valvular pendulous volume leads to backward-unloading of the right ventricle. Consequently, established cut-offs for normal systolic performance may overestimate true systolic RVF. Methods: A retrospective analysis was performed entailing all patients who underwent TTE at our institution between 1 January 2013 and 31 December 2016. Only patients with normal left ventricular systolic function and with no other valvular lesion were included. All recorded loops were re-read by one experienced examiner. Patients without severe TR (defined as vena contracta width ≥7 mm) were excluded. All-cause 2-year mortality was chosen as the end-point. The prognostic value of several RVF parameters was tested. Results: The final cohort consisted of 220 patients, 88/220 (40%) were male. Median age was 69 years (IQR 52–79), all-cause two-year mortality was 29%, median TAPSE was 19 mm (15–22) and median FAC was 42% (30–52). In multivariate analysis, TAPSE with the cutoff 17 mm and FAC with the cutoff 35% revealed non-significant hazard ratios (HR) of 0.75 (95%CI 0.396–1.421, p = 0.38) and 0.845 (95%CI 0.383–1.867, p = 0.68), respectively. TAPSE with the cutoff 19 mm and visual eyeballing significantly predicted survival with HRs of 0.512 (95%CI 0.296–0.886, p = 0.017) and 1.631 (95%CI 1.101–2.416, p = 0.015), respectively. Conclusions: This large-scale all-comer study confirms that RVF is one of the main drivers of mortality in patients with severe isolated TR. However, the current cut-offs for established echocardiographic parameters did not predict survival. Further studies should investigate the prognostic value of higher thresholds for RVF parameters in these patients.

Right Ventricular Function in Left Ventricular Disease: Pathophysiology and Implications

2013 ◽  
Vol 22 (7) ◽  
pp. 507-511 ◽  
Author(s):  
Konstantin Schwarz ◽  
Satnam Singh ◽  
Dana Dawson ◽  
Michael P. Frenneaux
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Left Ventricular
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