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Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy

Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulmonary arterial systolic pressure (PASP) has prognostic significance in patients undergoing cardiac resynchronization therapy (CRT). Methods: Patients undergoing CRT were prospectively included. The prima...

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Autores principales: Deaconu, Silvia, Deaconu, Alexandru, Scarlatescu, Alina, Petre, Ioana, Onciul, Sebastian, Vijiiac, Aura, Zamfir, Diana, Marascu, Gabriela, Iorgulescu, Corneliu, Radu, Andrei Dan, Bogdan, Stefan, Vatasescu, Radu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8198639/
https://www.ncbi.nlm.nih.gov/pubmed/34072825
http://dx.doi.org/10.3390/jcm10112442
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author Deaconu, Silvia
Deaconu, Alexandru
Scarlatescu, Alina
Petre, Ioana
Onciul, Sebastian
Vijiiac, Aura
Zamfir, Diana
Marascu, Gabriela
Iorgulescu, Corneliu
Radu, Andrei Dan
Bogdan, Stefan
Vatasescu, Radu
author_facet Deaconu, Silvia
Deaconu, Alexandru
Scarlatescu, Alina
Petre, Ioana
Onciul, Sebastian
Vijiiac, Aura
Zamfir, Diana
Marascu, Gabriela
Iorgulescu, Corneliu
Radu, Andrei Dan
Bogdan, Stefan
Vatasescu, Radu
author_sort Deaconu, Silvia
collection PubMed
description Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulmonary arterial systolic pressure (PASP) has prognostic significance in patients undergoing cardiac resynchronization therapy (CRT). Methods: Patients undergoing CRT were prospectively included. The primary endpoint was adverse cardiovascular events (death and HF-related hospitalizations). RV global longitudinal strain (RVGLS) and RV free wall strain (RVfwS) were measured by speckle tracking and indexed to echocardiographic estimated PASP. Results: A total of 54 patients (64.0 ± 13.8 years; 58% male) were included. After 33 ± 12.9 months, the primary endpoint occurred in 18 patients. Baseline RVGLS/PASP and RVfwS/PASP showed good discriminative ability for response to CRT (AUC = 0.88, 95% CI (0.74–1) and AUC = 0.87, 95% CI (0.77–1)). RVGLS/PASP and RVfwS/PASP were significantly associated with high risk of events at univariate analysis (HR 0.039, 95% CI (0.001–0.8) p < 0.05, respectively HR = 0.049, 95% CI (0.0033–0.72), p < 0.05). Upon multivariate Cox regression analysis, RVGLS/PASP and RVfwS/PASP remained associated with high risk of events (HR 0.018, 95% CI (0.0005–0.64), p = 0.02 and HR 0.015, 95% CI (0.0004–0.524), p = 0.01) after correction for gender, etiology, QRS duration and morphology. Conclusions: Indexing RV longitudinal strain (global and free wall) by PASP provides a parameter, which independently identifies patients with high risk of cardiovascular events and predicts non-response to CRT.
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spelling pubmed-81986392021-06-14 Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy Deaconu, Silvia Deaconu, Alexandru Scarlatescu, Alina Petre, Ioana Onciul, Sebastian Vijiiac, Aura Zamfir, Diana Marascu, Gabriela Iorgulescu, Corneliu Radu, Andrei Dan Bogdan, Stefan Vatasescu, Radu J Clin Med Article Background: We aimed to evaluate whether right ventricle (RV) longitudinal strain indexed to pulmonary arterial systolic pressure (PASP) has prognostic significance in patients undergoing cardiac resynchronization therapy (CRT). Methods: Patients undergoing CRT were prospectively included. The primary endpoint was adverse cardiovascular events (death and HF-related hospitalizations). RV global longitudinal strain (RVGLS) and RV free wall strain (RVfwS) were measured by speckle tracking and indexed to echocardiographic estimated PASP. Results: A total of 54 patients (64.0 ± 13.8 years; 58% male) were included. After 33 ± 12.9 months, the primary endpoint occurred in 18 patients. Baseline RVGLS/PASP and RVfwS/PASP showed good discriminative ability for response to CRT (AUC = 0.88, 95% CI (0.74–1) and AUC = 0.87, 95% CI (0.77–1)). RVGLS/PASP and RVfwS/PASP were significantly associated with high risk of events at univariate analysis (HR 0.039, 95% CI (0.001–0.8) p < 0.05, respectively HR = 0.049, 95% CI (0.0033–0.72), p < 0.05). Upon multivariate Cox regression analysis, RVGLS/PASP and RVfwS/PASP remained associated with high risk of events (HR 0.018, 95% CI (0.0005–0.64), p = 0.02 and HR 0.015, 95% CI (0.0004–0.524), p = 0.01) after correction for gender, etiology, QRS duration and morphology. Conclusions: Indexing RV longitudinal strain (global and free wall) by PASP provides a parameter, which independently identifies patients with high risk of cardiovascular events and predicts non-response to CRT. MDPI 2021-05-31 /pmc/articles/PMC8198639/ /pubmed/34072825 http://dx.doi.org/10.3390/jcm10112442 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Deaconu, Silvia
Deaconu, Alexandru
Scarlatescu, Alina
Petre, Ioana
Onciul, Sebastian
Vijiiac, Aura
Zamfir, Diana
Marascu, Gabriela
Iorgulescu, Corneliu
Radu, Andrei Dan
Bogdan, Stefan
Vatasescu, Radu
Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy
title Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy
title_full Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy
title_fullStr Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy
title_full_unstemmed Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy
title_short Ratio between Right Ventricular Longitudinal Strain and Pulmonary Arterial Systolic Pressure: Novel Prognostic Parameter in Patients Undergoing Cardiac Resynchronization Therapy
title_sort ratio between right ventricular longitudinal strain and pulmonary arterial systolic pressure: novel prognostic parameter in patients undergoing cardiac resynchronization therapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8198639/
https://www.ncbi.nlm.nih.gov/pubmed/34072825
http://dx.doi.org/10.3390/jcm10112442
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