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ASSESSMENT OF RIGHT VENTRICULAR DYSFUNCTION IN PULMONARY HYPERTENSION: WHICH ECHOCARDIOGRAPHIC PARAMETER IS BEST?
A1490 JACC April 1, 2014 Volume 63, Issue 12
Pulmonary Hypertension and Venous Thrombo-embolic Disease Assessment of Right Ventricular Dysfunction in Pulmonary Hypertension: Which Echocardiographic Parameter is Best? Poster Contributions Hall C Sunday, March 30, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease III Abstract Category: 23. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease Presentation Number: 1188-211 Authors: Ramaimon Tunthong, Garvan Kane, Mayo Clinic, Rochester, MN, USA Background: While pulmonary hypertension is characterized by elevations in pressures, outcomes are invariably determined by right ventricular (RV) adaptation. RV ejection fraction, the recognized reference standard of RV function, requires either a CT, MRI or specialized echo offline analysis that is time intensive. The best echo parameter to predict a reduced RVEF is not clear. Methods: 206 pts (68% female, age 62 ± 15 yrs), referred for assessment of known or suspected PH, were prospectively enrolled. All had conventional echo (GE) measures of systolic function online as part of their routine clinical study including average free wall systolic strain by speckle tracking. Patients also had acquisition of a 3D dataset for off-line blinded assessment of RVEF on the independent TomTec platform. An abnormal RVEF was defined at ≤ 42%. The optimal modality to predict a reduced RVEF was assessed by receiver operating characteristic curves. Results: The average RVSP was 55 ± 21 mmHg with an estimated RA pressure of 8 ± 4 mmHg. The average RVEF was 48 ± 7% with RV end diastolic volume index of 93 ± 20 mL/m². The predictive powers of standard measures of RV systolic function for a reduced RVEF are displayed in the table. Conclusion: Systolic strain of the RV free wall by speckle tracking echo has emerged as a simple measure of longitudinal contractility that can be accomplished easily as part of a standard examination. Here we demonstrate that strain is the most accurate predictor of a reduced RVEF, with an optimal threshold of -17%.
Pulmonary Hypertension and Venous Thrombo-embolic Disease Assessment of Right Ventricular Dysfunction in Pulmonary Hypertension: Which Echocardiographic Parameter is Best? Poster Contributions Hall C Sunday, March 30, 2014, 9:45 a.m.-10:30 a.m.
Session Title: Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease III Abstract Category: 23. Pulmonary Hypertension and Pulmonary Thrombo-embolic Disease Presentation Number: 1188-211 Authors: Ramaimon Tunthong, Garvan Kane, Mayo Clinic, Rochester, MN, USA Background: While pulmonary hypertension is characterized by elevations in pressures, outcomes are invariably determined by right ventricular (RV) adaptation. RV ejection fraction, the recognized reference standard of RV function, requires either a CT, MRI or specialized echo offline analysis that is time intensive. The best echo parameter to predict a reduced RVEF is not clear. Methods: 206 pts (68% female, age 62 ± 15 yrs), referred for assessment of known or suspected PH, were prospectively enrolled. All had conventional echo (GE) measures of systolic function online as part of their routine clinical study including average free wall systolic strain by speckle tracking. Patients also had acquisition of a 3D dataset for off-line blinded assessment of RVEF on the independent TomTec platform. An abnormal RVEF was defined at ≤ 42%. The optimal modality to predict a reduced RVEF was assessed by receiver operating characteristic curves. Results: The average RVSP was 55 ± 21 mmHg with an estimated RA pressure of 8 ± 4 mmHg. The average RVEF was 48 ± 7% with RV end diastolic volume index of 93 ± 20 mL/m². The predictive powers of standard measures of RV systolic function for a reduced RVEF are displayed in the table. Conclusion: Systolic strain of the RV free wall by speckle tracking echo has emerged as a simple measure of longitudinal contractility that can be accomplished easily as part of a standard examination. Here we demonstrate that strain is the most accurate predictor of a reduced RVEF, with an optimal threshold of -17%.