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Right atrial and ventricular strain detects subclinical changes in right ventricular function in precapillary pulmonary hypertension.
Vos, J L; Leiner, T; van Dijk, A P J; van der Zwaan, H B; Sieswerda, G Tj; Snijder, R J; Post, M C; Vonk, M C; van Leuven, S; Vart, P; Snoeren, M; Hirsch, A; El Messaoudi, S; Nijveldt, R; Driessen, M M P.
Afiliación
  • Vos JL; Department of Cardiology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
  • Leiner T; Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • van Dijk APJ; Department of Cardiology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
  • van der Zwaan HB; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Sieswerda GT; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Snijder RJ; Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The Netherlands.
  • Post MC; Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Vonk MC; Department of Cardiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
  • van Leuven S; Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Vart P; Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Snoeren M; Department of Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
  • Hirsch A; Department of Radiology, Radboud University Medical Center, Nijmegen, The Netherlands.
  • El Messaoudi S; Department of Cardiology and Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, The Netherlands.
  • Nijveldt R; Department of Cardiology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
  • Driessen MMP; Department of Cardiology, Radboud University Medical Center, Geert Grooteplein 10, 6525 GA, Nijmegen, The Netherlands.
Int J Cardiovasc Imaging ; 38(8): 1699-1710, 2022 Aug.
Article en En | MEDLINE | ID: mdl-35190941
Right ventricular (RV) ejection fraction (EF) by cardiac magnetic resonance (CMR) correlates to outcome in precapillary pulmonary hypertension (pPH) patients, but is insensitive to early changes. Strain might provide incremental information. In this study, we compare right atrial (RA) and RV strain in pPH patients to healthy controls, and evaluate the prognostic value of strain in pPH. In this cross-sectional study, 45 pPH patients and 20 healthy controls underwent CMR, and feature-tracking derived RA and RV strain were evaluated. pPH patients had impaired RA reservoir and conduit strain, and RV longitudinal strain (LS), compared to healthy controls. In pPH patients with preserved RVEF (≥ 50%, n = 18), RA reservoir (35% ± 9 vs. 41% ± 6, p = 0.02) and conduit strain (16% ± 8 vs. 23% ± 5, p = 0.004), and RV-LS (-25% ± 4 vs. -31% ± 4, p < 0.001) remained impaired, compared to healthy controls. The association of strain with the primary endpoint (combination of all-cause death, lung transplantation, and heart failure hospitalization) was evaluated using a multivariable Cox regression model. RV-LS (HR 1.18, 95%-CI 1.04-1.34, p = 0.01) and RA strain (reservoir: HR 0.87, 95%-CI 0.80-0.94, p = 0.001; conduit: HR 0.85, 95%-CI 0.75-0.97, p = 0.02, booster: HR 0.81, 95%-CI 0.71-0.92, p = 0.001) were independent predictors of outcome, beyond clinical and imaging features. In conclusion, pPH patients have impaired RA strain and RV-LS, even when RVEF is preserved. In addition, RA strain and RV-LS were independent predictors of adverse prognosis. These results emphasize the incremental value of RA and RV strain analyses, to detect alterations in RV function, even before RVEF declines.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Disfunción Ventricular Derecha / Hipertensión Pulmonar Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Int J Cardiovasc Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Fibrilación Atrial / Disfunción Ventricular Derecha / Hipertensión Pulmonar Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Int J Cardiovasc Imaging Asunto de la revista: DIAGNOSTICO POR IMAGEM Año: 2022 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos