Echocardiographic Evaluation of Pulmonary Haemodynamics - A Review

2021 ◽  
Vol 13 (2) ◽  
pp. 200-216
Author(s):  
MS Kabir ◽  
AAS Majumder ◽  
AFKU Ahmed ◽  
KA Rubaiyat ◽  
A Jhan ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Comprehensive Evaluation ◽  
Heart Diseases ◽  
Prognostic Significance ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Echocardiographic Evaluation ◽  
Pulmonary Haemodynamics ◽  
Mere Presence ◽  
Systolic And Diastolic Function

Pulmonary haemodynamic status has got significant clinical and prognostic significance both in structural and nonstructural heart diseases. But diagnostic accuracy depends on much care in evaluation and logical correlation of different echocardiographic parameters. Though the Doppler studies play crucial role in estimating Pulmonary haemodynamics, careful observation of 2-D measurements of different structures as well as RV systolic and diastolic function are vital issues to be addressed and correlated for diagnostic accuracy. Tricuspid Valve, RVOT and Pulmonary valve pathologies also demand vivid correlation while estimating PA pressures and pulmonary vascular resistance. Mere presence of elevated pulmonary artery systolic pressure is not enough to define pulmonary hypertension (PH). Before declaring a patient having PH a comprehensive evaluation of right heart haemodynamics is to be performed carefully to avoid unnecessary cardiac catheterization or to avoid inadvertent initiation of PH therapy. Cardiovasc. j. 2021; 13(2): 200-216

scholarly journals Immediate impact of percutaneous transvenous mitral commissurotomy on right ventricular function

2017 ◽  
Vol 14 (2) ◽  
pp. 19-24
Author(s):  
Bishal KC ◽  
Rabi Malla ◽  
Ram Kishore Shah ◽  
Anish Hirachan ◽  
Binay Kumar Rauniyar ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Clinical Symptoms ◽  
Longitudinal Velocity ◽  
Prognostic Significance ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Tei Index ◽  
Long Term Outcome ◽  
Rv Function

Background and Aims: Abnormal Right Ventricular (RV) function affects the long term outcome and clinical symptoms in patients with mitral stenosis (MS). This study evaluates the immediate effect of Percutaneous Transmitral Commisurotomy (PTMC) on RV function.Methods: An observational, cross sectional study was done on 50 patients with rheumatic MS who underwent PTMC at Shahid Gangalal National Heart Center from Dec 2015 –Dec 2016. All underwent clinical evaluation and echocardiogram before and immediately after PTMC.Results: There was female preponderance with 66% being female. The mean age was 37.26 ± 10.63 years. There was immediate increase in the mitral valve area (MVA) from 0.87 ± 0.12cm2 to 1.54 ± 0.27cm2(p< 0.001). There was significant decrease in mean mitral diastolic gradient from 16.4 ± 8.8mmHg to 5 ± 1.5mmHg (p< 0.001), in the pulmonary artery systolic pressure 53.6 ± 21.83mmHg to 39.5 ± 14.67mmHg (p< 0.001), in the RV Tei index from 0.56 ± 0.08 to 0.40 ± 0.08 (p< 0.001). There was significant increase in TAPSE from 16.0 ± 1.50 to 18.6 ± 1.70 mm, (p<0.001) and the longitudinal velocity of excursion of the RV at the tricuspid annulus (RV S’) from 13.69 ± 3.33 cm/sec to 15.31 ± 3.07 cm/sec (p< 0.001)Conclusions: Successful PTMC can improve RV function as shown by the improvement in PASP, RV Tei index, TAPSE and RV S’. Further larger population studies are required to confirm the findings. Long term studies are important to determine the prognostic significance of improvement in RV function.Nepalese Heart Journal 2017; 14(2): 19-24

scholarly journals P1446 Correlation of B-Type natriuretic peptide with LV and RV function assessed by echocardiography in adults congenital heart diseases patients

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Kavouras ◽  
K Dimopoulos ◽  
A La Leggia ◽  
R Barracano ◽  
M Brida ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Natriuretic Peptide ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Systolic Dysfunction ◽  
Systolic Pressure ◽  
Diastolic Velocity ◽  
Systolic And Diastolic Function ◽  
Rv Function

Abstract Introduction Brain natriuretic peptide (BNP) is a well-established marker for heart failure in the general population however limited data are available on the value of BNP as a diagnostic and prognostic marker in adults with congenital heart disease (ACHD). The purpose of our study is to evaluate the relation between BNP levels and biventricular systolic and diastolic function in patients with ACHD. Methods We evaluated clinically stable ACHD patients who underwent echocardiography from May 2015 until January 2018. We studied the correlation of BNP with the degree of systolic and diastolic dysfunction of the left ventricle. Moreover we also investigate the relation of BNP with the right tricuspid annular plane systolic excursion (TAPSE), the fractional area change (FAC) and the pulmonary arterial systolic pressure (PASP). Results In total, 385 patients were included in our study (median age, 43 ±12 years; 61% male). Of the 385 patients, 193 (50%) had tetralogy of Fallot, 94 (24%) had systemic RV, including patients with transposition of the great arteries (TGA) after atrial switch operation (Mustard or Senning) and congenitally corrected TGA -ccTGA , 43 (11%) had univentricular hearts and Fontan physiology, 55 (14%) had other lesions. BNP levels were 66 ± 26 pg/mL and 93, ±31pg/mL, for patients with EF &gt; 50% and 50%&gt; EF &gt;35% respectively (p = 0.003). BNP levels correlate with parameters reflecting LV filling pressure, including transmitral early diastolic velocity (E) 81 ± 29pg/mL and its ratio to early diastolic annular myocardial tissue velocity (E/Ea) 77 ± 17pg/mL. (r=-0.607, p = 0.003 r=-0.598, p = 0.005, respectively) BNP levels were also significantly higher in patients with impaired tricuspid annular plane systolic excursion 87 ± 21 pg/mL (TAPSE &lt; 14mm; p = 0.002) and decreased RV FAC 81 ± 18 pg/mL (FAC &lt;35% P= 0.004) and in patients with PASP≥35 mmHg (p = 0.003). The ROC curve and logistic regression analysis spotted the role of BNP in identifying systolic and diastolic dysfunction patterns in ACHD patients. Conclusion: In clinical stable ACHD patiens BNP levels correlate well with LV systolic dysfunction as well as with impaired diastolic function. Furthermore patients with impaired RV function and increased PASP have raised BNP levels. Therefore monitoring BNP levels plays an important role in management of clinical stable ACHD patients

scholarly journals The Circulating MicroRNA-206 Level Predicts the Severity of Pulmonary Hypertension in Patients with Left Heart Diseases

2017 ◽  
Vol 41 (6) ◽  
pp. 2150-2160 ◽  
Author(s):  
Peng Jin ◽  
Wenzhu Gu ◽  
Yayu Lai ◽  
Wei Zheng ◽  
Qi Zhou ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Heart Diseases ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Pulmonary Artery Systolic Pressure ◽  
Circulating Microrna ◽  
Left Heart ◽  
Ventricular Ejection Fraction

Background: MicroRNA-206 (miR-206), a muscle-specific miRNA, regulates the growth of cardiac myocytes and pulmonary artery smooth muscle cells. However, it remains unknown whether miR-206 is involved in pulmonary hypertension (PH) due to left heart diseases (PH-LHD). This study was designed to investigate the correlation between miR-206 and PH in patients with LHD. Methods: In 82 consecutively enrolled LHD patients, we examined the serum levels of miR-206 and analyzed its correlations with pulmonary artery systolic pressure (PASP) and cardiac function. Another 36 age- and sex-matched subjects served as healthy controls. Results: The patients were divided into the LHD group (n=47, PASP<50 mmHg) and the PH-LHD group (n=35, PASP≥50 mmHg). The level of miR-206 was significantly decreased in the PH-LHD group compared with that of the LHD and healthy control groups. In addition, the miR-206 level was correlated with PASP (r=-0.305, p<0.001) but not with systemic blood pressure. Univariate analyses showed that miR-206, brain natriuretic peptide (BNP), left ventricular ejection fraction and left atrial longitudinal diameter (LAD) were significantly related to PASP. Multivariate regression analysis identified miR-206 as an independent predictive factor for PH. MiR-206 alone (cut-off <0.66) demonstrated a sensitivity of 68.60% and a specificity of 65.80% in predicting PH. Moreover, the combination of miR-206, BNP and LAD (cut-off 0.21) showed a sensitivity of 97.10% and a specificity of 80.30% in predicting PH in LHD patients. Conclusion: A decreased circulating miR-206 level was associated with increased PASP in LHD patients. Thus, the level of miR-206, especially combined with BNP and LAD, might be helpful in the detection of PH in LHD patients.

scholarly journals Correlation of Net Atrioventricular Compliance with the Outcome of Successful Percutaneous Transvenous Mitral Valve Commissurotomy

2016 ◽  
Vol 8 (2) ◽  
pp. 99-109 ◽  
Author(s):  
Rajib Ghosh ◽  
Abdullah Al Shafi Majumder ◽  
MM Hossain ◽  
Abdul Momen ◽  
M Aziz ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pressure Gradient ◽  
Left Atrial ◽  
Nyha Class ◽  
Prognostic Significance ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Significant Difference ◽  
Mean Pressure

Background: In patients with mitral stenosis the prognostic significance of net atrioventricular compliance has already been established. It was found that left atrial compliance significantly improve immediately after successful balloon mitral valvotomy. This study was conducted to evaluate the immediate improvement of atrioventricular compliance following percutaneous Transvenous mitral commissurotomy (PTMC) & to see the relation of post PTMC atrioventricular compliance with immediate clinical & other echocardiographic outcomes.Methods: This prospective observational study was undertaken in the Department of Cardiology, National Institute of Cardiovascular diseases, Dhaka. A total of 50 patients who had had successful PTMC were selected. All patients were evaluated clinically and echocardiographically 24 hours before PTMC, immediately after PTMC and 72 hours after PTMC.Results: Atrioventricular compliance improved significantly following PTMC (mean Cn 3.42 ± 1.64ml/mm Hg vs. 6.38 ± 2.81ml/mm Hg, p<0.001). After successful PTMC comparison of clinical & echocardiographic parameters revealed mitral valve area, pulmonary arterial systolic pressure, transmitral peak and mean pressure gradient and NYHA class for dyspnoea had statistically significant difference among patients with atrioventricular compliance >4 ml/mm of Hg and patients with atrioventricular compliance d”4ml/mm of Hg. NYHA class for heart failure, transmitral peak and mean pressure gradient, pulmonary artery systolic pressure were negatively correlated to atrioventricular compliance. Index left atrial anteroposterior diameter had no significant correlation with atrioventricular compliance.Conclusion: Successful PTMC is associated with immediate significant improvement in atrioventricular compliance. Atrioventricular compliance is inversely correlated with NYHA functional status, transmitral pressure gradient & pulmonary artery systolic pressure following successful PTMC. Post PTMC atrioventricular compliance is also positively correlated with pre PTMC atrioventricular compliance.Cardiovasc. j. 2016; 8(2): 99-109

Effect of acute lower respiratory tract infection on pulmonary artery pressure in children with post-tricuspid left-to-right shunt

2021 ◽  
pp. 1-5
Author(s):  
Sakshi Sachdeva ◽  
Shyam S. Kothari ◽  
Saurabh K. Gupta ◽  
Sivasubramanian Ramakrishnan ◽  
Anita Saxena
Keyword(s):  
Tract Infection ◽  
Pulmonary Artery ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Pulmonary Artery Pressure ◽  
Lower Respiratory Tract ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Artery Pressure

Abstract We sought to examine the influence of clinically severe lower respiratory tract infection on pulmonary artery pressure in children having CHD with post-tricuspid left-to-right shunt, as it may have physiological and clinical implications. In a prospective single-centre observational study, 45 children with post-tricuspid left-to-right shunt and clinically severe lower respiratory tract infection were evaluated during the illness and 2 weeks after its resolution. Pulmonary artery systolic pressure was estimated non-invasively using shunt gradient by echocardiography and systolic blood pressure measured non-invasively. Median pulmonary artery systolic pressure during lower respiratory tract infection was only mildly (although statistically significantly) elevated during lower respiratory tract infection [60 (42–74) versus 53 (40–73) mmHg, (p < 0.0001)]. However, clinically significant change in pulmonary artery systolic pressure defined as the increase of >10 mmHg was present in only 9 (20%) patients. In the absence of hypoxia or acidosis, only a small minority (9%, n = 4) showed significant pulmonary artery systolic pressure rise >10 mmHg. In the absence of hypoxia or acidosis, severe lower respiratory tract infection in patients with acyanotic CHD results in only mild elevation of pulmonary artery systolic pressure in most of the patients.

Regional disparities in the clinical profiles of patients with peripartum cardiomyopathy in Nigeria: results from the peripartum cardiomyopathy in Nigeria Registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Karaye ◽  
H Sai'du ◽  
S.A Balarabe ◽  
N.A Ishaq ◽  
U.G Adamu ◽  
...  
Keyword(s):  
Systolic Function ◽  
Economic Status ◽  
Healthcare Providers ◽  
Systolic Pressure ◽  
Peripartum Cardiomyopathy ◽  
Pulmonary Artery Systolic Pressure ◽  
Funding Source ◽  
Private Company ◽  
North West ◽  
Clinical Profiles

Abstract Background Peripartum cardiomyopathy (PPCM) seems to have varied epidemiology within and between countries. We recently reported that Kano (North-West Nigeria) has the highest known incidence of PPCM in the world, but the clinical profiles of the patients by regions have not been previously reported. In this study, we aimed to describe the regional differences (if any) in the clinical profiles of patients with PPCM in Nigeria. Methods We consecutively recruited 244 PPCM patients over 9 months from 3 hospitals in Kano (n=199; 81.6%) and from 11 hospitals spread across the North-Central, South-West, South-East and South-South zones (n=45; 18.4%) of Nigeria. Results The baseline characteristics of the patients are summarised in Table 1. 35 (17.6%) patients in Kano and 10 (23.2%) patients in other zones died (p=0.0523) after a median of 17 months. Conclusion PPCM patients in Kano were younger, had lower socio-economic status, presented to hospitals later, were less symptomatic, had larger sizes of cardiac chambers, worse right ventricular systolic function, higher pulmonary artery systolic pressure and were receiving less treatment at enrolment, than those in other zones in Nigeria. This information will be used for advocacy and interactions with healthcare providers. Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Dantata Group of Companies (Nigeria). Ammasco International Ltd. (Nigeria). Fortune Oil Mills Nigeria Ltd.

scholarly journals Atrial fibrillation and atrial tachycardia in patients with chronic thromboembolic pulmonary hypertension treated with pulmonary endarterectomy

2020 ◽  
Vol 22 (Supplement_F) ◽  
pp. F30-F37
Author(s):  
Stepan Havranek ◽  
Zdenka Fingrova ◽  
David Ambroz ◽  
Pavel Jansa ◽  
Jan Kuchar ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulmonary Hypertension ◽  
Atrial Tachycardia ◽  
Cox Regression ◽  
Systolic Pressure ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Walking Distance ◽  
Pulmonary Artery Systolic Pressure ◽  
Pulmonary Endarterectomy ◽  
Thromboembolic Pulmonary Hypertension

Abstract Atrial fibrillation (AF) and atrial tachycardia (AT) are frequently observed in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who were treated with pulmonary endarterectomy (PEA). Their prevalence and impact on prognosis of patients are not known. We analysed the prevalence of AF/AT and the clinical outcome in 197 patients with CTEPH treated with PEA (median age 62; interquartile range 53–68 years; 62% males). The prevalence of AF/AT was 29% (57 patients). Compared to patients without arrhythmia, the subjects with AF/AT were older [60 (50–67) vs. 62 (57–70) years], manifested an increased size of the left atrium [39 (35–44) vs. 45 (40–50) mm], had a reduced 6-min walking distance [411 (321–506) vs. 340 (254–460) m], and higher pulmonary artery systolic pressure after PEA [38 (30–47) vs. 45 (38–71) mmHg], all results with P-value &lt;0.05. During the follow-up with a median 4.2 (1.6–6.3) years, 45 (23%) patients died. In a multivariate Cox regression model only the male gender [hazard ratio (HR) 2.27, 95% confidence interval (CI) 1.15–4.50], a reduced 6-min walking distance (HR 3.67, 95% CI 1.74–7.73), and an increased New York Heart Association class (HR 8.56, 95% CI 4.17–17.60) were associated with mortality (P &lt; 0.05). The prevalence of AF/AT in patients with CTEPH treated with PEA is high. Arrhythmias are associated with reduced functional capacity but not with mortality.

Increased Brain Natriuretic Peptide as a Marker for Right Ventricular Dysfunction in Acute Pulmonary Embolism

2001 ◽  
Vol 86 (11) ◽  
pp. 1193-1196 ◽  
Author(s):  
Igor Tulevski ◽  
Alexander Hirsch ◽  
Bernd-Jan Sanson ◽  
Hans Romkes ◽  
Ernst van der Wall ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Brain Natriuretic Peptide ◽  
Right Ventricular ◽  
Natriuretic Peptide ◽  
Acute Pulmonary Embolism ◽  
Prognostic Significance ◽  
Systolic Pressure ◽  
Clinical Importance ◽  
Acute Pe ◽  
Rv Function

SummaryRight ventricular (RV) function is of major prognostic significance in patients with acute pulmonary embolism (PE). The aim of the present study was to evaluate the role of neurohormone plasma brain natriuretic peptide (BNP) in assessing RV function in patients with acute PE.BNP levels were measured in 16 consecutive patients with acute PE as diagnosed by high probability lung scintigraphy or pulmonary angiography. Twelve healthy age-matched volunteers served as controls. All 16 patients underwent standard echocardiography and blood tests during the first hour of presentation. In the patient group, survival was studied for a period of 30 days. Plasma BNP levels in patients with acute PE were higher than in controls (7.2 [95% CI 0.4 to 144.6] versus 1.4[95% CI 0.4 to 4.6] pmol/L, p = 0.0008). Plasma BNP was significantly higher in 5 patients with RV dysfunction compared to 11 patients with normal RV function (40.2 [95% CI 7.5 to 214.9] versus 3.3 [95% CI 0.4 to 24.9] pmol/L, p = 0.0003). RV systolic pressure was not significantly correlated with BNP (r = 0.42, p = ns).In conclusion, plasma BNP neurohormone levels might be of clinical importance as a supplementary tool for assessment of RV function in patients with acute PE.

Sign in / Sign up

Export Citation Format

Share Document