Key result
3D echocardiography-derived right ventricular volumes and ejection fraction correlated strongly with cardiac magnetic resonance measurements (r=0.64-0.91, p<0.0001) in heart transplant recipients.
Why the study?
Right ventricular dilatation and dysfunction are common in heart transplant patients and exacerbated by residual pulmonary hypertension, but the comparative ability of echocardiographic modalities to evaluate RV function remained unclear.
Does comprehensive echocardiography accurately evaluate right ventricular function compared to CMR in heart transplant recipients?
Observational (n=35)
Does comprehensive echocardiography accurately evaluate right ventricular function compared to CMR in heart transplant recipients?
3D echocardiography is the most accurate echocardiographic method for evaluating right ventricular function in heart transplant recipients, with 3D-RVEF and RV free wall longitudinal strain best reflecting the subclinical impact of residual pulmonary hypertension.
Answers are grounded in this paper and cite their sources.
3D echocardiography may best evaluate RV function in HTx; leaves open need for prospective validation before guiding PH management.
OBJECTIVE: Right ventricular (RV) dilatation and dysfunction are usually present in heart transplant (HTx) patients and worsened with residual pulmonary hypertension (PH). We aimed to determine the ability of different echocardiographic modalities to evaluate RV function in comparison with cardiac magnetic resonance (CMR) and their relations with pulmonary hemodynamics in HTx patients. METHODS: A total of 62 data sets [echocardiographic, hemodynamic, and CMR] were acquired from 35 HTx patients. Comprehensive echocardiography, including two-dimensional (2D) transthoracic echocardiography, speckle tracking echocardiography, and three-dimensional (3D) echocardiography, was performed. Mean pulmonary artery pressure (mPAP) was obtained invasively from right heart catheterization. The correlations between all echocardiographic parameters and CMR imaging data and the differences between patients with and without residual PH were evaluated. RESULTS: Diastolic and systolic RV volumes and RV ejection fraction (RVEF) by 3D echocardiography correlated strongly with CMR-derived volumes and RVEF (r = .91, r = .79, r = .64; p < .0001 for each, respectively). Among other parameters, RV fractional area change (r = .439; p < .001) and RV free wall longitudinal strain (RVFW-LS) (r = -.34; p < .05) correlated moderately with CMR-RVEF, whereas tricuspid annulus S' velocity (r = .29; p < .05) and tricuspid annular systolic plane excursion (r = .27; p < .05) correlated weakly with CMR-RVEF. Additionally, 3D-RVEF and RVFW-LS were significantly decreased in studies with mPAP ≥ 20 mm Hg in comparison to those with mPAP < 20 mm Hg (47.7 ± 3.7 vs. 50.9 ± 5.3, p = .04 and -15.5 ± 3.1 vs. -17.5 ± 3, p = .03, respectively). CONCLUSION: The best method for the evaluation of RV function in HTx recipients is 3D echocardiography. Besides, the subclinical impact of residual PH on RV function can be best determined by RVFW-LS and 3D-RVEF in these patients.
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Çolak et al. (2023) conducted an observational in Heart transplant recipients (n=35). 3D echocardiography and speckle tracking echocardiography vs. Cardiac magnetic resonance (CMR) was evaluated on Correlation of diastolic and systolic RV volumes and RVEF by 3D echocardiography with CMR-derived values (r = 0.64 to 0.91, p=<.0001). 3D echocardiography-derived right ventricular volumes and ejection fraction correlated strongly with cardiac magnetic resonance measurements (r=0.64-0.91, p<0.0001) in heart transplant recipients.
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