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Right ventricular diastolic stiffness in idiopathic pulmonary arterial hypertension

Silvia Rain, Taco Kind, Louis Handoko, Bart Boerrigter, Nicolaas Westerhof, Jolanda van der Velden, Anton Vonk-Noordegraaf, Frances de Man
European Respiratory Journal 2011 38: p2317; DOI:
Silvia Rain
Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands
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Taco Kind
Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands
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Louis Handoko
Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands
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Bart Boerrigter
Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands
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Nicolaas Westerhof
Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands
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Jolanda van der Velden
Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands
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Anton Vonk-Noordegraaf
Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands
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Frances de Man
Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, Netherlands
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Abstract

Introduction: Idiopathic pulmonary arterial hypertension (iPAH) is a fatal disease with grim prognosis due to subsequent development of right heart failure (RHF). Findings in experimental pulmonary hypertension models suggest RHF is associated with increased diastolic stiffness.

Objective: This study investigates whether right ventricle (RV) diastolic stiffness is increased in iPAH patients.

Methods: Right heart catheterization (RHC) and MRI were performed in 28 patients suspected with iPAH. Based on pulmonary artery pressure, patients were divided into controls (7) and iPAH (21). Diastolic elastance (diastolic stiffness), was quantified by the slope of diastolic pressure-volume relation, constructed by plotting RV end-systolic volumes and begin-diastolic pressures against RV end-diastolic volumes and end-diastolic pressures. Subsequently, we investigated whether diastolic elastance was associated with disease severity by comparing patients with lower RV stoke volumes (RVSV) and patients with higher RVSV.

Results: Diastolic elastance was significantly altered in iPAH (iPAH 0.25±0.04 vs. Con 0.07±0.006, p=0.024). In addition, patients with lower RVSV had significantly higher diastolic elastance (LowSV0.38±0.05 vs HighSV 0.114±0.02).

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Conclusion: This study demonstrates that RV diastolic stiffness is increased in iPAH-patients and is associated with disease severity. In future studies we will investigate the prognostic relevance of these changes.

  • © 2011 ERS
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Right ventricular diastolic stiffness in idiopathic pulmonary arterial hypertension
Silvia Rain, Taco Kind, Louis Handoko, Bart Boerrigter, Nicolaas Westerhof, Jolanda van der Velden, Anton Vonk-Noordegraaf, Frances de Man
European Respiratory Journal Sep 2011, 38 (Suppl 55) p2317;

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Right ventricular diastolic stiffness in idiopathic pulmonary arterial hypertension
Silvia Rain, Taco Kind, Louis Handoko, Bart Boerrigter, Nicolaas Westerhof, Jolanda van der Velden, Anton Vonk-Noordegraaf, Frances de Man
European Respiratory Journal Sep 2011, 38 (Suppl 55) p2317;
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More in this TOC Section

  • Right ventricular regional functional changes in patients with pulmonary hypertension of different etiology
  • Right ventricular systolic and diastolic function measured by tissue Doppler imaging in various forms of pulmonary hypertension
Show more 262. Physiology of human pulmonary hypertension

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