TY - JOUR T1 - Right ventricular dyssynchrony and exercise capacity in idiopathic pulmonary arterial hypertension JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01419-2016 VL - 49 IS - 6 SP - 1601419 AU - Roberto Badagliacca AU - Silvia Papa AU - Gabriele Valli AU - Beatrice Pezzuto AU - Roberto Poscia AU - Manuela Reali AU - Giovanna Manzi AU - Elisa Giannetta AU - Daniele Berardi AU - Susanna Sciomer AU - Paolo Palange AU - Francesco Fedele AU - Robert Naeije AU - Carmine Dario Vizza Y1 - 2017/06/01 UR - http://erj.ersjournals.com/content/49/6/1601419.abstract N2 - Survival in patients with pulmonary arterial hypertension (PAH) is determined by right ventricular (RV) function adaptation to afterload. How altered RV function impacts on exercise capacity in PAH is not exactly known.104 idiopathic PAH (IPAH) patients aged 52±14 years underwent a diagnostic right heart catheterisation, a comprehensive echocardiography including two-dimensional speckle tracking for RV dyssynchrony evaluation and a cardiopulmonary exercise test. Multivariate analyses were performed to identify independent predictors of peak oxygen uptake (peak V′O2).A first multivariate analysis of only resting haemodynamic variables identified cardiac index, right atrial (RA) pressure and pulmonary arterial compliance as independent predictors, with low predictive capacity (r2=0.31; p<0.001). A second multivariate analysis model which considered only echocardiographic parameters but without RV dyssynchrony, identified RV fractional area change (FAC) and RA area as independent predictors with still low predictivity (r2=0.35; p<0.001). Adding RV dyssynchrony to the second model increased its predictivity (r2=0.48; p<0.001). Repetition of the three multivariate analyses in patients with preserved RVFAC confirmed that inclusion of RV dyssynchrony results in the highest predictive capability of peak V′O2 (r2=0.53; p=0.001).A comprehensive echocardiography with speckle tracking-derived assessment of the heterogeneity of RV contraction improves the prediction of aerobic exercise capacity in IPAH.Speckle tracking assessment of RV dyssynchrony improves the prediction of aerobic exercise capacity in IPAH http://ow.ly/yHyh30bedtD ER -