[Association between echocardiography derived right ventricular function parameters with cardiac magnetic resonance derived right ventricular ejection fraction and 6-minute walk distance in pulmonary hypertension patients]

Zhenzhen Wang, Zhenwen Yang, Zheng Wan, Tielian Yu, Lili Jia, Xin Du, Canliang Huang
Zhonghua Xin Xue Guan Bing za Zhi 2014, 42 (9): 748-52

OBJECTIVE: To explore the association between transthoracic echocardiography (TTE) derived right ventricular (RV) function parameters with cardiovascular magnetic resonance imaging (CMR) derived RV ejection fraction (RVEF) and 6 minute walk distance (6MWD) in pulmonary hypertension (PH) patients.

METHODS: A total of 40 PH patients (37 pulmonary artery hypertension (PAH) and 3 chronic thromboembolic pulmonary hypertension (CTEPH)) hospitalized in our department between March 2011 and March 2013 were enrolled in this study. PH diagnosis was established by right heart catheterization and TTE, CMR and 6MWT were performed within one week post TTE examination. TTE parameters included: tricuspid annular peak systolic excursion (TAPSE), isovolumic contraction acceleration (IVA), peak systolic velocity (S') at the lateral tricuspid annulus derived from tissue Doppler imaging, RV myocardial performance index (MPI) and RV fractional area change (FAC). RVEF was obtained from CMR.

RESULTS: S' (r = 0.69, P < 0.001), TAPSE (r = 0.65, P < 0.001), FAC (r = 0.62, P < 0.001), IVA (r = 0.43, P = 0.006), MPI (r = -0.38, P < 0.05) correlated significantly with RVEF obtained from CMR. The best parameter to detect RVEF ≤ 20% was S' < 8.79 cm/s (area under the ROC curve was 0.92 (95% CI: 0.72-0.84), sensitivity 0.91, and specificity 0.80) . No correlation was found between TTE parameters and 6MWD and between RVEF obtained from CMR and 6MWD.

CONCLUSION: S', derived from tissue Doppler imaging correlates best with RVEF obtained from CMR and may facilitate simple and quantitative assessment of RV function. The best parameter to detect RVEF ≤ 20% is S' < 8.79 cm/s.

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