The non-invasive echocardiographic assessment of right ventricular myocardial work in a healthy population

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Healthy (n=263). Intervention: Non-invasive echocardiographic assessment of right ventricular myocardial work. Primary outcome: Normal reference values for right ventricular myocardial work indices.

Jian Wu; Xinyi Huang; Kunhui Huang; Qiumei Gao; Yuxuan Chen; Yuan Tian; Yiruo Tang; Biqin Lin; Maolong Su

doi:10.1080/00015385.2023.2189870

April 11, 2023Acta cardiologica. SupplementumOpen Access

The non-invasive echocardiographic assessment of right ventricular myocardial work in a healthy population

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Key result

Echocardiography defines normal reference ranges for RV myocardial work in healthy adults.

n=263

Why the study?

The physiological determinants of non-invasive right ventricular myocardial work have not been studied, and reference ranges for normal indices have yet to be established.

What are the normal reference values for non-invasive right ventricular myocardial work (RVMW) indices in a healthy population?

Study Design

Type

Cross-Sectional (n=263)

Structured PICO

What are the normal reference values for non-invasive right ventricular myocardial work (RVMW) indices in a healthy population?

P

Population

263 healthy Asian volunteers (median age 34 years, 38% male) with normal physical examination, normal electrocardiogram, normal two-dimensional echocardiography, and no history of cardiovascular or respiratory disease.

I

Intervention

Non-invasive echocardiographic assessment of right ventricular myocardial work (RVMW) using right ventricular pressure-strain loop (RVPSL)

O

Outcome

Normal reference values for RVMW indices (RV global work index [RVGWI], RV global constructive work [RVGCW], RV global wasted work [RVGWW], and RV global work efficiency [RVGWE])surrogate

This study establishes normal reference ranges for non-invasive right ventricular myocardial work indices by echocardiography, demonstrating significant sex and age differences.

Limitations

Acquiring and quantifying datasets using a single provider platform may affect the applicability of reference values to other platforms.
Commercial software used is specifically designed to measure left ventricular myocardial work, not right ventricular myocardial work.
Right ventricular afterload was estimated by calculating pulmonary pressure rather than by performing direct measurements.
Non-invasive right ventricular pressure-strain loops were not validated by invasive right heart catheterization.
Potential selection bias due to the exclusion of subjects with poor tracking quality or lack of holosystolic regurgitation.
Unknown whether the results can be generalized to non-Asian subjects.
Acquiring and quantifying RVMW datasets using a single provider platform may affect applicability to other platforms
Commercial software used is specifically designed to measure LVMW, not RVMW
RV afterload was estimated by calculating pulmonary pressure rather than direct measurements
Approximately one in four healthy subjects were excluded due to poor TR envelope, causing potential selection bias
Cannot rule out subclinical cardiovascular or respiratory disease, particularly in elderly individuals
Unknown whether results can be generalized to non-Asian subjects

Implication

Offers sex-specific RV work references in healthy adults; leaves open validation before clinical adoption.

Abstract

BACKGROUND: Non-invasive right ventricular (RV) myocardial work (RVMW) is the latest indicator used to assess RV function. Nevertheless, the physiological determinants of RVMW have not been studied, and reference ranges for normal RVMW indices have yet to be established. METHODS: A total of 263 healthy volunteers (median age: 34 years, males: 38%) were prospectively enrolled. RVMW indices were analysed by an RV pressure-strain loop (RVPSL) in specific software. RESULTS: The lowest values of the RVMW indices in males and females were 133 mmHg% and 206 mmHg% for RV global work index (RVGWI), 165 mmHg% and 241 mmHg% for RV global constructive work (RVGCW) and 78% and 83% for RV global work efficiency (RVGWE), respectively. The highest values for RV global wasted work (RVGWW) in males and females were 67 mmHg% and 69 mmHg%, respectively. RVGWI and RVGCW were significantly lower in males than those in females. RVGWW significantly increased with age in males and females. RVGWE significantly decreased with age in females. Multivariable analysis revealed that RVGWI, RVGCW and RVGWE increased as pulmonary artery systolic pressure (PASP) increased. CONCLUSIONS: Normal reference values of non-invasive RVMW were obtained by echocardiography. Quantitative data on RVMW could be essential in clinical work and clinical experiments.

Discussion

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Cite This Study

Wu et al. (2023) conducted a cross-sectional in Healthy (n=263). Non-invasive echocardiographic assessment of right ventricular myocardial work was evaluated on Normal reference values for right ventricular myocardial work indices. Non-invasive echocardiography established normal reference values for right ventricular myocardial work in healthy adults, with the lowest expected RV global work index being 133 mmHg% in males and 206 mmHg% in females.

synapsesocial.com/papers/6a0501b77d96552991e45df9 https://doi.org/10.1080/00015385.2023.2189870

Topics

Echocardiography

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The non-invasive echocardiographic assessment of right ventricular myocardial work in a healthy population

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Topics

The non-invasive echocardiographic assessment of right ventricular myocardial work in a healthy population

Study Design

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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Topics

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