Speckle-Tracking Echocardiography Identified Interventricular Dyssynchrony and Exercise Capacity in Idiopathic Pulmonary Arterial Hypertension

2019 ◽  
Author(s):  
B. Liu ◽  
W. Wu ◽  
Q. Zeng ◽  
Z. Liu ◽  
L. Niu ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Exercise Capacity ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Interventricular Dyssynchrony ◽  
Pulmonary Arterial

scholarly journals Impact of right ventricular dyssynchrony on prognosis of patients with idiopathic pulmonary arterial hypertension

2019 ◽  
Vol 9 (4) ◽  
pp. 204589401988360
Author(s):  
Xiao-Ling Cheng ◽  
Bing-Yang Liu ◽  
Wei-Chun Wu ◽  
Wen Li ◽  
Li Huang ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
World Health ◽  
Peak Strain ◽  
Ventricular Dyssynchrony ◽  
Pulmonary Arterial

Idiopathic pulmonary arterial hypertension is a progressive disease with high mortality with an increasing burden of right ventricular. Right ventricular dyssynchrony was observed in idiopathic pulmonary arterial hypertension, but the association with mortality is unclear. This study aimed to investigate the impact of right ventricular dyssynchrony on the survival of idiopathic pulmonary arterial hypertension. A total of 116 patients with idiopathic pulmonary arterial hypertension were enrolled in this study. All these patients underwent comprehensive clinical evaluation. Right ventricular dyssynchrony was assessed by two-dimensional speckle-tracking echocardiography. The time to peak strain (Tpeak) of right ventricular segments were obtained. Right ventricular dyssynchrony was quantified by the standard deviation of the heart rate-corrected Tpeak of right ventricular four segments. All patients were followed up and the primary endpoint was all cause of death. Results found patients with significant right ventricular dyssynchrony present with advanced World Health Organization functional class, worse hemodynamic status and right ventricular function. Right ventricular dyssynchrony was an independent predictive factor for the survival of idiopathic pulmonary arterial hypertension. Kaplan–Meier survival curves showed patients with right ventricular dyssynchrony had worse prognosis. In conclusion, right ventricular dyssynchrony analyzed by speckle-tracking echocardiography provided added value to hemodynamic and echocardiographic parameters in evaluating the survival of patients with idiopathic pulmonary arterial hypertension.

Clinical impact of subcutaneous treprostinil in trisomy 21 patient with pulmonary arterial hypertension associated with CHD

2022 ◽  
pp. 1-3
Author(s):  
Ryusuke Numata ◽  
Kiyohiro Takigiku ◽  
Kouta Takei
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Pulmonary Artery ◽  
Arterial Hypertension ◽  
Exercise Capacity ◽  
Trisomy 21 ◽  
Pulmonary Artery Hypertension ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Clinical Impact ◽  
Pulmonary Arterial ◽  
Hypertension In Children

Abstract Subcutaneous treprostinil is commonly used to improve idiopathic pulmonary arterial hypertension in children. However, its effectiveness has not been reported in trisomy 21. We report the case of 9-year-old boy in trisomy 21 with CHD-pulmonary artery hypertension after surgical correction of CHD. Haemodynamics and exercise capacity dramatically improved with a transition from oral selexipag to subcutaneous treprostinil.

scholarly journals Right ventricular dyssynchrony and exercise capacity in idiopathic pulmonary arterial hypertension

2017 ◽  
Vol 49 (6) ◽  
pp. 1601419 ◽  
Author(s):  
Roberto Badagliacca ◽  
Silvia Papa ◽  
Gabriele Valli ◽  
Beatrice Pezzuto ◽  
Roberto Poscia ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Exercise Capacity ◽  
Speckle Tracking ◽  
Multivariate Analyses ◽  
Right Atrial ◽  
Pulmonary Arterial ◽  
Rv Function

Survival in patients with pulmonary arterial hypertension (PAH) is determined by right ventricular (RV) function adaptation to afterload. How altered RV function impacts on exercise capacity in PAH is not exactly known.104 idiopathic PAH (IPAH) patients aged 52±14 years underwent a diagnostic right heart catheterisation, a comprehensive echocardiography including two-dimensional speckle tracking for RV dyssynchrony evaluation and a cardiopulmonary exercise test. Multivariate analyses were performed to identify independent predictors of peak oxygen uptake (peakV′O2).A first multivariate analysis of only resting haemodynamic variables identified cardiac index, right atrial (RA) pressure and pulmonary arterial compliance as independent predictors, with low predictive capacity (r2=0.31; p<0.001). A second multivariate analysis model which considered only echocardiographic parameters but without RV dyssynchrony, identified RV fractional area change (FAC) and RA area as independent predictors with still low predictivity (r2=0.35; p<0.001). Adding RV dyssynchrony to the second model increased its predictivity (r2=0.48; p<0.001). Repetition of the three multivariate analyses in patients with preserved RVFAC confirmed that inclusion of RV dyssynchrony results in the highest predictive capability of peakV′O2(r2=0.53; p=0.001).A comprehensive echocardiography with speckle tracking-derived assessment of the heterogeneity of RV contraction improves the prediction of aerobic exercise capacity in IPAH.

scholarly journals The Correlation of Decreased Heart Rate Recovery and Chronotropic Incompetence with Exercise Capacity in Idiopathic Pulmonary Arterial Hypertension Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Changwei Wu ◽  
Jian Guo ◽  
Hui Liu ◽  
Bigyan Pudasaini ◽  
Wenlan Yang ◽  
...  
Keyword(s):  
Heart Rate ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Exercise Capacity ◽  
Poor Prognosis ◽  
Heart Rate Recovery ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Chronotropic Incompetence ◽  
Severe Limitation ◽  
Pulmonary Arterial

We show by this study that a decrease in HRR1 in IPAH patients is associated with severe limitation of exercise capacity. HRR1 < 16 beats and CI just after completion of a CPET could be an indicator of poor prognosis.

scholarly journals Impaired Left Ventricular Longitudinal Function in Idiopathic Pulmonary Arterial Hypertension Children

2016 ◽  
Vol 1 (2) ◽  
pp. 146-152 ◽  
Author(s):  
Iolanda Muntean ◽  
Carmen Șuteu ◽  
Rodica Togănel
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Systolic Strain ◽  
Pulmonary Arterial ◽  
Dyssynchrony Index

Abstract Background: Pulmonary arterial hypertension is associated with right ventricular dilation and failure. As a result, left ventricular geometry is affected by shifting of the interventricular septum towards the left ventricle. Aim of the study: The aim of the study was to assess the effect of chronic right ventricular pressure overload on left ventricular longitudinal function and synchronicity in idiopathic pulmonary arterial hypertension children, using speckle-tracking echocardiography. Material and methods: We prospectively evaluated 13 children (5 with idiopathic pulmonary arterial hypertension and 8 sex- and age-matched controls) using conventional and speckle-tracking echocardiography and clinical status (WHO functional class). Left ventricular longitudinal strain curve was generated for 17 segments and global left ventricular longitudinal peak systolic strain was calculated. Dyssynchrony index of the left ventricle was determined calculating the standard deviation of time to peak-systolic strain for 12 left ventricular, 6 basal and 6 midventricular segments, from short axis views. Results: Strain imaging showed significantly decreased global left ventricular longitudinal strain and increased dyssynchrony index in idiopathic pulmonary arterial hypertension patients as compared with controls (−16.80 ± 2.94 vs. −21.50 ± 1.60, p = 0.003, and 53.80 ± 16.72 vs. 22.25 ± 6.18, p=0.0001, respectively). There was a significant correlation between left ventricular longitudinal strain, dyssynchrony index and right ventricular fractional area changes (r = −0.66, p = 0.013, and r = −0.72, p = 0.005, respectively), right ventricular myocardial performance index (r = 0.86, p = 0.0001, and r = 0.93, p = 0.000, respectively), and LV eccentricity index (r = 0.82, p=0.001, and r = 0.93, p = 0.000, respectively) in the study population as a whole. Conclusions: Left ventricular longitudinal systolic strain and synchronicity are impaired in idiopathic pulmonary arterial hypertension children with normal left ventricular ejection fraction.

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