scholarly journals Impaired Global Right Ventricular Longitudinal Strain Predicts Long-Term Adverse Outcomes in Patients with Pulmonary Arterial Hypertension

2015 ◽  
Vol 23 (2) ◽  
pp. 91 ◽  
Author(s):  
Jae-Hyeong Park ◽  
Margaret M. Park ◽  
Samar Farha ◽  
Jacqueline Sharp ◽  
Erika Lundgrin ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Adverse Outcomes ◽  
Pulmonary Arterial

Right ventricular longitudinal strain with CMR can more accurately estimate right ventricular functional reserve in rats with pulmonary arterial hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Sato ◽  
Y Someya ◽  
Y Takahashi ◽  
K Kumasaka ◽  
W Sato ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Weight Ratio ◽  
Contractile Properties ◽  
Funding Source ◽  
Functional Reserve ◽  
Pulmonary Arterial ◽  
Cmr Imaging

Abstract Background Right ventricular (RV) function is an important prognostic factor in patients with pulmonary arterial hypertension (PAH). Recently, CMR has become an attractive modality for follow up and providing prognosis in the patients, and strain has been used as a newer parameter to assess contractile properties of ventricle. It has not yet been established, however, whether RV strain with CMR can estimate RV functional reserve in the patients with PAH. Purpose We focused on CMR imaging of RV, investigating whether RV longitudinal strain can estimate RV functional reserve using a rat model with PAH. Method Rats were given a subcutaneous injection of 60 mg/kg monocrotaline (MCT-rats) or solvent (Ctr-rats). Four weeks after the injection, 25% of MCT-rats died due to RV failure. In the survivors of MCT- (n=19) and Ctr-rats (n=5), retrospective ECG-gated cine MR (16 phases/beat) was imaged with a 7T scanner. Subsequently, we measured RV pressure (RVP) via right internal jugular vein and dissected trabeculae (length = 1.45±0.07 mm, width = 334±27 μm, thickness = 114±6 μm) from RVs. We calculated weight ratio of RV free wall to left ventricle (LV) by RV/(LV+septum). Trabeculae were electrically stimulated with 2-s stimulus intervals, and force was measured using a silicon strain gauge (0.7 mM extracellular Ca2+, 24°C). To determine contractile properties of RV muscle, dF/dt was calculated. Using CMR imaging, we measured RV ejection fraction (RVEF) and RV longitudinal strain (RVLS). To modulate RVP, we intravenously injected 5 nmol endothelin-1 (ET-1) and again measured RVEF and RVLS. Results MCT-rats showed higher systolic RVP (62.5±16.6 vs. 25.9±1.86 mmHg, p<0.01) and higher weight ratio of RV (0.60±0.03 vs. 0.28±0.02, p<0.05). In CMR imaging, MCT-rats showed lower RVEF (36.1±11.2 vs. 64.8±8.4%, p<0.001) and lower RVLS (−18±9 vs. −30±1%, p<0.05). In trabeculae from RVs, MCT-rats showed lower developed force and lower dF/dt (p<0.01). Correlation between RVLS and dF/dt was higher (n=20, r=0.53, p<0.05) than that between RVEF and dF/dt (r=0.24). In addition, RVLS and dF/dt had already been decreased in 5 MCT-rats with relatively preserved RVEF (>50%), suggesting that RVLS decreases earlier than RVEF in MCT-rats. Ten minutes after the injection of ET-1, RVP was increased from 49.4±7.9 to 57.9±6.4 mmHg in MCT-rats (n=6). In MCT-rats with preserved RVEF and decreased RVLS, the increase in RVP chiefly decreased RVEF while it did not change RVLS and RVEF in Ctr-rats, meaning that RV functional reserve had been decreased in MCT-rats. In trabeculae, developed force and dF/dt were increased after the addition of 0.1 μM ET-1 in MCT- (n=11, p<0.01) and Ctr-rats (n=4, p<0.01). Conclusion These results suggest that in rats with PAH, RVLS obtained from CMR can estimate RV functional reserve earlier and more accurately than RVEF. Therefore, RV strain with CMR may become an important parameter to assess RV functional reserve in patients with PAH. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Young Scientists

scholarly journals RIGHT VENTRICULAR LONGITUDINAL STRAIN: A SUPERIOR MEASURE OF OUTCOMES IN PATIENTS WITH PULMONARY ARTERIAL HYPERTENSION

2015 ◽  
Vol 65 (10) ◽  
pp. A1074 ◽  
Author(s):  
Karima Addetia ◽  
Francesco Maffessanti ◽  
Karen Dugan ◽  
Michael Wilkinson ◽  
Mardi Gomberg-Maitland ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Pulmonary Arterial

Progressive Changes in Right Ventricular Geometric Shortening and Long-term Survival in Pulmonary Arterial Hypertension

CHEST Journal ◽  
2012 ◽  
Vol 141 (4) ◽  
pp. 935-943 ◽  
Author(s):  
Gert-Jan Mauritz ◽  
Taco Kind ◽  
J. Tim Marcus ◽  
Harm-Jan Bogaard ◽  
Mariëlle van de Veerdonk ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Term Survival ◽  
Long Term Survival ◽  
Pulmonary Arterial

scholarly journals Right ventricular afterload predicts long-term transition from parenteral to oral treprostinil in pulmonary arterial hypertension

2018 ◽  
Vol 8 (4) ◽  
pp. 204589401879727 ◽  
Author(s):  
Travis Maestas ◽  
Lillian M. Hansen ◽  
Rebecca R. Vanderpool ◽  
Ankit A. Desai ◽  
Sophia Airhart ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Right Ventricular Afterload ◽  
Ventricular Afterload ◽  
Pulmonary Arterial

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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