RT Journal Article
SR Electronic
T1 Right ventricular dyssynchrony measured using speckle tracking strain as a predictive factor in pulmonary hypertension patients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p1512
VO 38
IS Suppl 55
A1 Bouchra Lamia
A1 Luis-Carlos Molano
A1 Catherine Viacroze
A1 Antoine Cuvelier
A1 Jean-Francois Muir
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p1512.abstract
AB Introduction: RV function is a major prognosis factor in pulmonary hypertension patients. TAPSE has been described as a good predictive factor in this population. Right ventricular speckle tracking strain analysis can quantify regional contraction and identify RV dyssynchrony.Objective: To test whether RV dyssynchrony exists in PH patients and can predict RV function.Design: Prospective study.Results: 42 simultaneous measurements were prospectively obtained using pulmonary artery catheterization and a TTE: hemodynamics, TAPSE, RVEDA/LVEDA. The speckle tracking analysis was used to generate 6 segmental RV strain curves. Time to peak strain from each of 6 time-strain curves was determined with dyssynchrony defined as the difference between earliest and latest segments. Global radial strain was calculated.MPAP was 38±9 mmHg, PAOP was 12±4 mmHg, cardiac index was 3.0±1.1 L/min/m2. TAPSE was 17±7, RVEDA/LVEDA was 1.17±0.64. RV global strain was decreased: -12.7±5.7% and RV had dyssynchrony 155±93 msec.RV dyssynchrony was significantly correlated to RV dilation: y= 75x + 68, r2=0.25, p<0.001 but not correlated to TAPSE: y = 5.77x + 247, r2=0.12, p=0.056.Conclusion: In our PH patients, we found RV dyssynchrony diagnosed using echocardiographic speckle tracking strain analysis while usual indices of RV function as TAPSE are still normal. This result should be confirmed in a larger population and ask the question. Assessment of RV dyssynchrony could be used for the follow-up of PH patients: predictive factor and non-invasive hemodynamic monitoring. RV resynchronisation therapy could be considered to improve the prognosis of PH patients.