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Use of noninvasive tools in primary pulmonary hypertension to assess the correlation of right ventricular function with functional capacity and to predict outcome

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Abstract

 

Most patients with Primary Pulmonary Hypertension (PPH) have severe exertional limitation which ultimately leads to right heart failure and death. The purpose of the study was to assess the correlation between right ventricular (RV) systolic and diastolic noninvasive variables and exercise tolerance, as well as the predictors of adverse outcome in treated patients.

Methods

We prospectively studied 29 patients, 17 with PPH and 12 with PPH due to collagen disease. RV parameters were assessed by echocardiography and Radionuclide ventriculography. Pulmonary function and clinical profile were assessed by 6 min walk test and NYHA class. The patients were followed-up during 2 years for cardiac death and cardiac deterioration.

Results

Mean age was 51 ± 15 years, 22 (78%) women. NYHA class1 in 2 pts, class 2 in 17, class 3 in 8 and class 4 in 2 pts. Pulmonary function (DLCO) was low in 25 (86%) pts, mean 22 ± 48%. Six minutes walk distance was 358 ± 132 m, RVEF was 34 ± 11% (range 16–51%). Among RV variables, RVEF, RA area and TR were independently correlated to 6 min walk. Within follow up of 2 years, there were 10 patients with adverse outcome (4 deaths and 6 deteriorated to NYHA class 3 and 4). Among all clinical and noninvasive variables, RVEF only was correlated to adverse outcome.

Conclusion

The noninvasive tests of RVEF, RA size and TR were closely correlated to exercise tolerance. However, among the various clinical, functional and RV variables, RVEF was the only variable correlated with adverse outcome in pts with PPH.

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Authors and Affiliations

  1. Cardiology Department, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Beilinson Campus, Petah Tiqva, 49100, Israel

    Nili Zafrir, Alejandro Solodky, Alex Sagie, Jaqueline Sulkes & Israel Mats

  2. Pulmonary Institute, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Beilinson Campus, Petah Tiqva, 49100, Israel

    Boris Zingerman, Daniel Ben-Dayan & M. R. Kramer

Authors
  1. Nili Zafrir
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  2. Boris Zingerman
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  3. Alejandro Solodky
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  4. Daniel Ben-Dayan
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  5. Alex Sagie
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  6. Jaqueline Sulkes
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  7. Israel Mats
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  8. M. R. Kramer
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Correspondence to Nili Zafrir.

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Zafrir, N., Zingerman, B., Solodky, A. et al. Use of noninvasive tools in primary pulmonary hypertension to assess the correlation of right ventricular function with functional capacity and to predict outcome. Int J Cardiovasc Imaging 23, 209–215 (2007). https://doi.org/10.1007/s10554-006-9140-5

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  • DOI: https://doi.org/10.1007/s10554-006-9140-5

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