Right Heart Chambers Longitudinal Strain Provides Enhanced Diagnosis and Categorization in Patients With Pulmonary Hypertension

Bibliographic Details
Title: Right Heart Chambers Longitudinal Strain Provides Enhanced Diagnosis and Categorization in Patients With Pulmonary Hypertension
Authors: Nilda Espinola-Zavaleta, Neftali Eduardo Antonio-Villa, Enrique C. Guerra, Navin C. Nanda, Lawrence Rudski, Ricardo Alvarez-Santana, Gyssele Camacho-Camacho, Alberto Aranda-Fraustro, Jorge Cossio-Aranda, Karina Zamora, Diego Oregel-Camacho, Javier Ivan Armenta-Moreno, Joaquin Berarducci, Erick Alexanderson-Rosas
Source: Frontiers in Cardiovascular Medicine, Vol 9 (2022)
Publisher Information: Frontiers Media S.A., 2022.
Publication Year: 2022
Collection: LCC:Diseases of the circulatory (Cardiovascular) system
Subject Terms: echocardiography, right ventricular free wall longitudinal strain, right atrial global longitudinal strain, pulmonary hypertension, systolic pulmonary arterial pressure, Diseases of the circulatory (Cardiovascular) system, RC666-701
More Details: BackgroundIncreased systolic pulmonary arterial pressure (sPAP) could lead to the mechanical dysfunction and myocardial fibrosis of the right heart chambers. Echocardiographic strain analysis has not been adequately studied in patients with pulmonary hypertension (PH).Study design and methodsA cross-sectional cohort of patients with suspected PH and echocardiographic strain evaluation was recruited. The cut-off values of peak tricuspid regurgitation velocity (TRV) with the low probability of PH (≤2.8 m/s), intermediate probability (2.9–3.4 m/s, without other echo PH signs), and high probability of PH (2.9–3.4 m/s with other echo PH signs and >3.4 m/s) categories were studied by right ventricular and right atrial (RA) strain analysis in a sample of 236 patients.ResultsThe results showed that 58 (56.9%) patients had low, 15 (14.7%) had intermediate, and 29 (28.4%) had a high probability of PH. We observed a negative association between right ventricular free wall strain (RV-FWS) and atrial global strain with sPAP. With the increase in PH severity, RA reservoir, conduit, and contraction (booster) strain values decreased. The identified cut-off values of strain parameters had an adequate ability to detect PH severity categories. In addition, the post-mortem biopsies of right heart chambers from subjects with known severe PH were analyzed to quantify myocardial fibrosis. Our sample of right heart biopsies (n = 12) demonstrated an association between increased sPAP before death and right ventricular and RA fibrosis.ConclusionMechanical dysfunction and fibrosis in the right chambers are associated with increased sPAP. Right ventricular and atrial strain could provide enhancement in the diagnosis and categorization of subjects with suspected PH.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2297-055X
Relation: https://www.frontiersin.org/articles/10.3389/fcvm.2022.841776/full; https://doaj.org/toc/2297-055X
DOI: 10.3389/fcvm.2022.841776
Access URL: https://doaj.org/article/010851be0cd14ea6b3caa879174e1a56
Accession Number: edsdoj.010851be0cd14ea6b3caa879174e1a56
Database: Directory of Open Access Journals
More Details
ISSN:2297055X
DOI:10.3389/fcvm.2022.841776
Published in:Frontiers in Cardiovascular Medicine
Language:English