Does the assessment of right ventricular dyssynchrony by speckle tracking echocardiography improve the prediction of exercise capacity (peak V'O2) in patients with idiopathic pulmonary arterial hypertension?
Assessment of right ventricular dyssynchrony using speckle tracking echocardiography significantly improves the prediction of aerobic exercise capacity in patients with idiopathic pulmonary arterial hypertension.
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; p2=0.35; p2=0.48; pV'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.
Badagliacca et al. (Thu,) studied this question.