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Evaluation of right ventricular strain in two separate cohorts with precapillary pulmonary hypertension
Evaluation for right ventricular (RV) dysfunction is an important part of risk assessment in care of patients with pulmonary hypertension (PH) as it is associated with morbidity and mortality. Echocardiography provides a widely available and acceptable method to assess RV function. RV global longitu...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9985931/ https://www.ncbi.nlm.nih.gov/pubmed/36883189 http://dx.doi.org/10.1002/pul2.12204 |
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author | Crossman, Lauren M. Rajaram, Priyanka Hart, Charles Michael Pernetz, Maria A. Sahu, Anurag Jokhadar, Maan Book, Wendy M. Fisher, Micah R. Trammell, Aaron W. |
author_facet | Crossman, Lauren M. Rajaram, Priyanka Hart, Charles Michael Pernetz, Maria A. Sahu, Anurag Jokhadar, Maan Book, Wendy M. Fisher, Micah R. Trammell, Aaron W. |
author_sort | Crossman, Lauren M. |
collection | PubMed |
description | Evaluation for right ventricular (RV) dysfunction is an important part of risk assessment in care of patients with pulmonary hypertension (PH) as it is associated with morbidity and mortality. Echocardiography provides a widely available and acceptable method to assess RV function. RV global longitudinal strain (RVGLS), a measure of longitudinal shortening of RV deep muscle fibers obtained by two‐dimensional echocardiography, was previously shown to predict short‐term mortality in patients with PH. The purpose of the current study was to assess the performance of RVGLS in predicting 1‐year outcomes in PH. We retrospectively identified 83 subjects with precapillary PH and then enrolled 50 consecutive prevalent pulmonary arterial hypertension (PAH) subjects into a prospective validation cohort. Death as well as combined morbidity and mortality events at 1 year were assessed as outcomes. In the retrospective cohort, 84% of patients had PAH and the overall 1‐year mortality rate was 16%. Less negative RVGLS was marginally better than tricuspid annular plane systolic excursion (TAPSE) as a predictor for death. However, in the prospective cohort, 1‐year mortality was only 2%, and RVGLS was not predictive of death or a combined morbidity and mortality outcome. This study supports that RV strain and TAPSE have similar 1‐year outcome predictions but highlights that low TAPSE or less negative RV strain measures are often false‐positive in a cohort with low baseline mortality risk. While RV failure is considered the final common pathway for disease progression in PAH, echocardiographic measures of RV function may be less informative of risk in serial follow‐up of treated PAH patients. |
format | Online Article Text |
id | pubmed-9985931 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-99859312023-03-06 Evaluation of right ventricular strain in two separate cohorts with precapillary pulmonary hypertension Crossman, Lauren M. Rajaram, Priyanka Hart, Charles Michael Pernetz, Maria A. Sahu, Anurag Jokhadar, Maan Book, Wendy M. Fisher, Micah R. Trammell, Aaron W. Pulm Circ Research Articles Evaluation for right ventricular (RV) dysfunction is an important part of risk assessment in care of patients with pulmonary hypertension (PH) as it is associated with morbidity and mortality. Echocardiography provides a widely available and acceptable method to assess RV function. RV global longitudinal strain (RVGLS), a measure of longitudinal shortening of RV deep muscle fibers obtained by two‐dimensional echocardiography, was previously shown to predict short‐term mortality in patients with PH. The purpose of the current study was to assess the performance of RVGLS in predicting 1‐year outcomes in PH. We retrospectively identified 83 subjects with precapillary PH and then enrolled 50 consecutive prevalent pulmonary arterial hypertension (PAH) subjects into a prospective validation cohort. Death as well as combined morbidity and mortality events at 1 year were assessed as outcomes. In the retrospective cohort, 84% of patients had PAH and the overall 1‐year mortality rate was 16%. Less negative RVGLS was marginally better than tricuspid annular plane systolic excursion (TAPSE) as a predictor for death. However, in the prospective cohort, 1‐year mortality was only 2%, and RVGLS was not predictive of death or a combined morbidity and mortality outcome. This study supports that RV strain and TAPSE have similar 1‐year outcome predictions but highlights that low TAPSE or less negative RV strain measures are often false‐positive in a cohort with low baseline mortality risk. While RV failure is considered the final common pathway for disease progression in PAH, echocardiographic measures of RV function may be less informative of risk in serial follow‐up of treated PAH patients. John Wiley and Sons Inc. 2023-03-05 /pmc/articles/PMC9985931/ /pubmed/36883189 http://dx.doi.org/10.1002/pul2.12204 Text en © 2023 The Authors. Pulmonary Circulation published by John Wiley & Sons Ltd on behalf of Pulmonary Vascular Research Institute. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Research Articles Crossman, Lauren M. Rajaram, Priyanka Hart, Charles Michael Pernetz, Maria A. Sahu, Anurag Jokhadar, Maan Book, Wendy M. Fisher, Micah R. Trammell, Aaron W. Evaluation of right ventricular strain in two separate cohorts with precapillary pulmonary hypertension |
title | Evaluation of right ventricular strain in two separate cohorts with precapillary pulmonary hypertension |
title_full | Evaluation of right ventricular strain in two separate cohorts with precapillary pulmonary hypertension |
title_fullStr | Evaluation of right ventricular strain in two separate cohorts with precapillary pulmonary hypertension |
title_full_unstemmed | Evaluation of right ventricular strain in two separate cohorts with precapillary pulmonary hypertension |
title_short | Evaluation of right ventricular strain in two separate cohorts with precapillary pulmonary hypertension |
title_sort | evaluation of right ventricular strain in two separate cohorts with precapillary pulmonary hypertension |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9985931/ https://www.ncbi.nlm.nih.gov/pubmed/36883189 http://dx.doi.org/10.1002/pul2.12204 |
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