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- Title
Echocardiographic estimation of right ventricular diastolic stiffness based on pulmonary regurgitant velocity waveform analysis in precapillary pulmonary hypertension.
- Authors
Nagai, Yui; Murayama, Michito; Kaga, Sanae; Shima, Hideki; Tsuneta, Satonori; Yokoyama, Shinobu; Nishino, Hisao; Goto, Mana; Suzuki, Yukino; Yanagi, Yusuke; Ishizaka, Suguru; Iwano, Hiroyuki; Nakamura, Junichi; Sato, Takahiro; Tsujino, Ichizo
- Abstract
Right ventricular (RV) diastolic stiffness is an independent predictor of survival and is strongly associated with disease severity in patients with precapillary pulmonary hypertension (PH). Therefore, a fully validated echocardiographic method for assessing RV diastolic stiffness needs to be established. This study aimed to compare echocardiography-derived RV diastolic stiffness and invasively measured pressure-volume loop-derived RV diastolic stiffness in patients with precapillary PH. We studied 50 consecutive patients with suspected or confirmed precapillary PH who underwent cardiac catheterization, magnetic resonance imaging, and echocardiography within a 1-week interval. Single-beat RV pressure-volume analysis was performed to determine the gold standard for RV diastolic stiffness. Elevated RV end-diastolic pressure (RVEDP) was defined as RVEDP ≥ 8 mmHg. Using continuous-wave Doppler and M-mode echocardiography, an echocardiographic index of RV diastolic stiffness was calculated as the ratio of the atrial-systolic descent of the pulmonary artery-RV pressure gradient derived from pulmonary regurgitant velocity (PRPGDAC) to the tricuspid annular plane movement during atrial contraction (TAPMAC). PRPGDAC/TAPMAC showed significant correlation with β (r = 0.54, p < 0.001) and RVEDP (r = 0.61, p < 0.001). A cut-off value of 0.74 mmHg/mm for PRPGDAC/TAPMAC showed 83% sensitivity and 93% specificity for identifying elevated RVEDP. Multivariate analyses indicated that PRPGDAC/TAPMAC was independently associated with disease severity in patients with precapillary PH, including substantial PH symptoms, stroke volume index, right atrial size, and pressure. PRPGDAC/TAPMAC, based on pulmonary regurgitation velocity waveform analysis, is useful for the noninvasive assessment of RV diastolic stiffness and is associated with prognostic risk factors in precapillary PH.
- Subjects
WAVE analysis; PULMONARY hypertension; DOPPLER echocardiography; MAGNETIC resonance imaging; ECHOCARDIOGRAPHY; CARDIAC pacing; VENTILATION
- Publication
International Journal of Cardiovascular Imaging, 2024, Vol 40, Issue 5, p1123
- ISSN
1569-5794
- Publication type
Article
- DOI
10.1007/s10554-024-03083-1