Journalartikel
Autorenliste: Yogeswaran, Athiththan; Rako, Zvonimir A.; Yildiz, Selin; Ghofrani, Hossein Ardeschir; Seeger, Werner; da Rocha, Bruno Brito; Gall, Henning; Kremer, Nils C.; Douschan, Philipp; Papa, Silvia; Vizza, Carmine Dario; Filomena, Domenico; Tedford, Ryan J.; Naeije, Robert; Richter, Manuel J.; Badagliacca, Roberto; Tello, Khodr
Jahr der Veröffentlichung: 2023
Zeitschrift: ERJ Open Research
Bandnummer: 9
Heftnummer: 5
eISSN: 2312-0541
Open Access Status: Gold
DOI Link: https://doi.org/10.1183/23120541.00226-2023
Verlag: European Respiratory Society
Background Right ventricular (RV) diastolic dysfunction may be prognostic in pulmonary hypertension (PH). However, its assessment is complex and relies on conductance catheterisation. We aimed to evaluate echocardiography-based parameters as surrogates of RV diastolic function, provide validation against the gold standard, end-diastolic elastance (Eed), and define the prognostic impact of echocardiography-derived RV diastolic dysfunction. Methods Patients with suspected PH who underwent right heart catheterisation including conductance catheterisation were prospectively recruited. In this study population, an echocardiography-based RV diastolic function surrogate was derived. Survival analyses were performed in patients with precapillary PH in the Giessen PH Registry, with external validation in patients with pulmonary arterial hypertension at Sapienza University (Rome). Results In the derivation cohort (n=61), the early/late diastolic tricuspid inflow velocity ratio (E/A) and early tricuspid inflow velocity/early diastolic tricuspid annular velocity ratio (E/e') did not correlate with Eed (p>0.05). Receiver operating characteristic analysis revealed a large area under the curve (AUC) for the peak lateral tricuspid annulus systolic velocity/right atrial area index ratio (S'/RAAi) to detect elevated Eed (AUC 0.913, 95% confidence interval (CI) 0.839-0.986) and elevated end-diastolic pressure (AUC 0.848, 95% CI 0.699-0.998) with an optimal threshold of 0.81 m(2).s(-1).cm(-1). Subgroup analyses demonstrated a large AUC in patients with preserved RV systolic function (AUC 0.963, 95% CI 0.882-1.000). Survival analyses confirmed the prognostic relevance of S'/RAAi in the Giessen PH Registry (n=225) and the external validation cohort (n=106). Conclusions Our study demonstrates the usefulness of echocardiography-derived S'/RAAi for noninvasive assessment of RV diastolic function and prognosis in PH.
Abstract:
Zitierstile
Harvard-Zitierstil: Yogeswaran, A., Rako, Z., Yildiz, S., Ghofrani, H., Seeger, W., da Rocha, B., et al. (2023) Echocardiographic evaluation of right ventricular diastolic function in pulmonary hypertension, ERJ Open Research, 9(5), Article 226. https://doi.org/10.1183/23120541.00226-2023
APA-Zitierstil: Yogeswaran, A., Rako, Z., Yildiz, S., Ghofrani, H., Seeger, W., da Rocha, B., Gall, H., Kremer, N., Douschan, P., Papa, S., Vizza, C., Filomena, D., Tedford, R., Naeije, R., Richter, M., Badagliacca, R., & Tello, K. (2023). Echocardiographic evaluation of right ventricular diastolic function in pulmonary hypertension. ERJ Open Research. 9(5), Article 226. https://doi.org/10.1183/23120541.00226-2023
Schlagwörter
AMERICAN SOCIETY; EUROPEAN ASSOCIATION; GUIDELINES; RECOMMENDATIONS; RELEVANCE; RIGHT ATRIAL; STIFFNESS; UPDATE
