Right ventricular dyssynchrony predicts clinical outcomes in patients with pulmonary hypertension

Mitsushige Murata, Toshimitsu Tsugu, Takashi Kawakami, Masaharu Kataoka, Yugo Minakata, Jin Endo, Hikaru Tsuruta, Yuji Itabashi, Yuichiro Maekawa, Keiichi Fukuda

研究成果: Article

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Background RV dyssynchrony has been described in patients with pulmonary hypertension (PH) and is an independent predictor of clinical worsening; however, the optimal method for measuring RV dyssynchrony has not been fully established. This study aimed to investigate whether RV dyssynchrony is correlated with hemodynamics and prognosis in PH patients and to identify the best parameter for evaluating RV dyssynchrony. Methods This study assessed 100 PH patients, measuring mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI) by right heart catheterization (RHC). RV strain curves were obtained using two-dimensional speckle-tracking echocardiography (2DSTE), and time from QRS onset to maximum peak longitudinal strain (Tmax) or time to first peak (Tfirst) was measured. Difference in time between the earliest and the latest segment (TD) and standard deviation (SD) of T in 6 segments with RV apex (− SD6) and 4 segments without RV apex (− SD4) were also assessed. Results Among all RV dyssynchrony parameters, Tmax-SD6 showed the strongest correlation with RV hemodynamics such as mPAP (R2 = 0.27, P < 0.0001) and PVR (R2 = 0.22, P < 0.0001). Univariate and multivariate Cox proportional hazard analyses showed that Tmax-SD6 significantly correlated with and independently predicted event-free survival in patients with PH. Conclusions RV dyssynchrony is a useful index for RV function and an independent predictor of clinical outcomes in patients with PH. In addition, the inclusion of apical motion is essential for the optimal assessment of RV dyssynchrony.

元の言語English
ページ(範囲)912-918
ページ数7
ジャーナルInternational Journal of Cardiology
228
DOI
出版物ステータスPublished - 2017 2 1

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

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