PS 08-67 RIGHT VENTRICULAR REMODELING IN PULMONARY HYPERTENSION DUE TO LEFT HEART DISEASE IN A SUB-SAHARAN TERTIARY HOSPITAL. AN ECHOCARDIOGRAPHIC ANALYSIS OF PATIENTS WITH HYPERTENSIVE HEART DISEASE.

2016 ◽  
Vol 34 (Supplement 1) ◽  
pp. e311
Author(s):  
Martin Abanda ◽  
Leopold Aminde ◽  
Felicité Kamdem ◽  
Bonaventure S Dzekem ◽  
Anastase Dzudie
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Right Ventricular ◽  
Ventricular Remodeling ◽  
Hypertensive Heart Disease ◽  
Tertiary Hospital ◽  
Left Heart ◽  
Left Heart Disease ◽  
Sub Saharan ◽  
Right Ventricular Remodeling

scholarly journals Different effects on right ventricular function in different etiology of secondary tricuspid regurgitation

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
WC Tsai ◽  
WY Lee ◽  
MS Huang ◽  
WH Lee
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Right Ventricular ◽  
Tricuspid Regurgitation ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Right Atrial ◽  
Left Heart ◽  
Left Heart Disease ◽  
Rv Function

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Ministry of Science and Technology, Excutive Yuan, Taiwan Background Tricuspid regurgitation (TR) is traditionally classified as primary or secondary TR. The effects of TR on right ventricular (RV) function were not consistent. We hypothesized that secondary TR is not a unique group, sophisticated sub-grouping can be useful for studying effects of TR on RV function. Methods 207 consecutive patients identified as significant TR (moderate and severe) by echocardiography were recruited. Standard measurements for right heart were done according to guideline. Lateral tricuspid annulus systolic tissue velocity (S’) and RV fractional area change (FAC) were used for RV function. We classified these patients into primary TR and 6 subgroups of secondary TR according to a new systemic approach. Results Mean age of subjects was 71.2 ± 14.7 years, and there were 84 (40.6%) male. There were 29 (14%) primary TR. Secondary TR was further classified into 6 groups included 18 (8.7%) pacemaker related, 81 (39.1 %) left heart diseases, 6 (2.9%) congenital heart diseases, 3 (1.4%) RV myopathy, 27 (13.0%) pulmonary hypertension, and 43 (20.8%) idiopathic TR. Among 4 major groups (congenital heart disease and RV myopathy were not included in analysis due to low numbers) of secondary TR, S’ was significant higher in idiopathic TR and RV FAC were higher in pacemaker related and idiopathic TR. RV dysfunction was defined as FAC < 35%. RV dysfunction presented mostly in pulmonary hypertension related TR and leastly in idiopathic TR (59.3% vs. 14%, p <0.001). Multivariate analysis using idiopathic TR as reference and controlled TR maximal velocity, RV end-diastolic area, right atrial area, and severity of TR, left heart disease related TR had higher risk of RV dysfunction (OR 4.178, 95% CI 1.490-11.703, p = 0.007). Conclusions Effects of TR on RV function were different among different subgroups of secondary TR. Left heart disease related TR had highest risk for RV dysfunction. Secondary TR should not be regarded as a single disease.

Modeling survival using decision tree analysis in pulmonary hypertension due to left heart disease. the prognostic significance of PVR <3WU when TAPSE <16mm

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
O Raitiere ◽  
E Berthelot ◽  
C Fauvel ◽  
P Guignant ◽  
N Si-Belkacem ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Decision Tree ◽  
Pressure Gradient ◽  
Right Ventricular ◽  
Decision Tree Analysis ◽  
Left Heart ◽  
Tree Analysis ◽  
Left Heart Disease ◽  
Wedge Pressure

Abstract Aims In 2019, PVR&lt;3 WU was adopted to stratify patients at low risk of pulmonary hypertension due to left heart disease (PH-LHD) as well those with isolated PH-LHD. We sought to evaluate whether the supervised machine learning with Decision Tree analysis that provides more information than Cox Proportional analysis by forming a hierarchy of multiple covariates, confirms this risk stratification. Methods 202 consecutive patients (mean age: 69±11 y, females 42%) with mean pulmonary artery pressure (mPAP)≥20mmHg and wedge pressure&gt;15mmHg were recruited. Transpulmonary pressure gradient ≥12mmHg, pulmonary vascular resistance (PVR) ≥3WU, diastolic pressure gradient ≥7mmHg, pulmonary arterial capacitance&lt;1.1 ml/mmHg, TAPSE&lt;16 mm, peak systolic tissue Doppler velocity&lt;10cm/s and right ventricular end-diastolic area ≥25 cm2 were the seven categorical values to enter the model. To predict the mortality from the Decision Tree, we used the CHAID method. Each node and branch were compared using survival analysis at 6-year follow-up. Results Mean PAP, wedge pressure, cardiac index, and PVR were 40.3±10.0mmHg, 22.3±7.1mm Hg, 2.9±0.8L/min/m2, and 3.6±2.1WU, respectively. Among the seven dichotomous values linked to the prognosis in PH-LHD, only 2 variables entered the model. To predict the mortality, TAPSE was first selected following by PVR. Compared to patients with PVR&lt;3WU and TAPSE ≥16mm, patients with PVR ≥3WU and TAPSE ≥16mm or patients with PVR ≥3WU and TAPSE &lt;16 mm has significant increased mortality (HR=3,0, 95% CI: [1,4–6,4], p=0.006 and HR=3,3, 95% CI: [1,6–6,9], p=0.002, respectively), while patients with PVR &lt;3WU and TAPSE &lt;16 mm exhibiting the worst prognosis (HR=7,2, 95% CI: [3,3–15,9], p=0.0001). Conclusion Used for solving regression and classification problems, decision tree analysis indicates that among 7 prognostic factors, TAPSE and PVR have to be interpreted altogether and simultaneously in PH-LHD for mortality assessment. Therefore, in future research, PVR &lt;3 WU should be understood primarily based on right ventricular systolic function assessed by echocardiography whether TAPSE is or not ≥16 mm. Funding Acknowledgement Type of funding source: None

Characterization of a Pulmonary Hypertension Model Caused by Left Heart Disease in Mouse

2020 ◽  
Author(s):  
L. K. Pallos ◽  
J. M. Dietrich ◽  
A. Simon ◽  
E. Carls ◽  
M. Matthey ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Left Heart ◽  
Left Heart Disease
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