Key result
Global area change ratio measured by 3D-STE correlated significantly with mean pulmonary artery pressure (r=0.671) and pulmonary vascular resistance (r=0.700) before balloon pulmonary angioplasty.
Why the study?
Right ventricular dysfunction is a prognostic factor for cardiovascular disease, but its mechanism and pathophysiology remain unknown.
Does RV-specific 3D-speckle-tracking echocardiography correlate with invasive hemodynamics and track regional RV recovery in patients with chronic thromboembolic pulmonary hypertension undergoing balloon pulmonary angioplasty?
Observational (n=29)
Does RV-specific 3D-speckle-tracking echocardiography correlate with invasive hemodynamics and track regional RV recovery in patients with chronic thromboembolic pulmonary hypertension undergoing balloon pulmonary angioplasty?
Effect estimate: r = 0.671
3D-speckle-tracking echocardiography provides regional RV parameters that correlate with invasive hemodynamics and can track distinct regional responses during treatment for chronic thromboembolic pulmonary hypertension.
RV-specific 3D-STE may aid hemodynamics assessment in CTEPH; leaves open prospective validation before clinical adoption.
Background Right ventricular (RV) dysfunction is a prognostic factor for cardiovascular disease. However, its mechanism and pathophysiology remain unknown. We investigated RV function using RV‐specific 3‐dimensional (3D)‐speckle‐tracking echocardiography (STE) in patients with chronic thromboembolic pulmonary hypertension. We also assessed regional wall motion abnormalities in the RV and chronological changes during balloon pulmonary angioplasty (BPA). Methods and Results Twenty‐nine patients with chronic thromboembolic pulmonary hypertension who underwent BPA were enrolled and underwent right heart catheterization and echocardiography before, immediately after, and 6 months after BPA. Echocardiographic assessment of RV function included both 2‐dimensional‐STE and RV‐specific 3D‐STE. Before BPA, global area change ratio measured by 3D‐STE was significantly associated with invasively measured mean pulmonary artery pressure and pulmonary vascular resistance ( r =0.671 and r =0.700, respectively). Dividing the RV into the inlet, apex, and outlet, inlet area change ratio showed strong correlation with mean pulmonary artery pressure and pulmonary vascular resistance before BPA ( r =0.573 and r =0.666, respectively). Only outlet area change ratio was significantly correlated with troponin T values at 6 months after BPA ( r =0.470), and its improvement after BPA was delayed compared with the inlet and apex regions. Patients with poor outlet area change ratio were associated with a delay in RV reverse remodeling after treatment. Conclusions RV‐specific 3D‐STE analysis revealed that 3D RV parameters were novel useful indicators for assessing RV function and hemodynamics in pulmonary hypertension and that each regional RV portion presents a unique response to hemodynamic changes during treatment, implicating that evaluation of RV regional functions might lead to a new guide for treatment strategies.
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Moriyama et al. (2020) conducted an observational in Chronic thromboembolic pulmonary hypertension (n=29). Balloon pulmonary angioplasty vs. Baseline (before procedure) was evaluated on Correlation of global area change ratio with mean pulmonary artery pressure and pulmonary vascular resistance (r = 0.671). Global area change ratio measured by 3D-STE correlated significantly with mean pulmonary artery pressure (r=0.671) and pulmonary vascular resistance (r=0.700) before balloon pulmonary angioplasty.
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