Author + information
- Khadija Alassas,
- Charles Burger,
- Christopher Austin,
- Preetham Kumar,
- Malik Al-Omari,
- Katherine Duello,
- Ricardo Pagan and
- Brian Shapiro
Echocardiographic assessment of right ventricular (RV) size and function is important for risk stratification in patients with pulmonary arterial hypertension (PAH). This study aimed to assess the predictive value of various echocardiographic parameters used to evaluate the RV.
Patients with PAH (N=219) who underwent a comprehensive evaluation including echocardiography and 6-minute walk (6MW) were included. Each initial echocardiogram was assessed for RV length, basal width, mid-ventricular width, area and volume in systole and diastole, ejection time (ET), and tricuspid closure opening time (TCO), tricuspid annular systolic excursion (TAPSE) and RV systolic excursion velocity (S'). Fractional area change (FAC=RV diastolic area-RV systolic area/RV diastolic area) and right ventricular index of myocardial performance (RIMP = TCO-ET/ET) were calculated. Survival data was obtained from chart review and social security death index. Kaplan-Meier curves were used to estimate survival and linear regression was used to evaluate correlation with 6MW.
Functional parameters including FAC, RIMP, TAPSE, and S’ correlated with 6MWD (p<0.05 for each) but only abnormal FAC (<35%) and RIMP (>0.4) were associated with worse mortality (Log-Rank <0.05). RV size based on length and volume had no association with 6MW or mortality but RV mid-ventricular width was associated with adverse outcome.
Measures of RV function have a greater ability to predict functional impairment and adverse outcomes in PAH compared to assessment of RV size alone. Accurate and reproducible determination of RV function is important for prognostic and functional assessment in these patients.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Pulmonary Hypertension: Right Ventricle / Congenital Heart Disease
Abstract Category: 27. Pulmonary Hypertension
Presentation Number: 1208-151
- 2013 American College of Cardiology Foundation