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September 28, 2012Circulation JournalOpen Access

Volumetric and Functional Assessment of Ventricles in Pulmonary Hypertension on 3-Dimensional Echocardiography

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Why the study?

Does 3-dimensional echocardiography accurately reflect invasive hemodynamic changes in patients with pulmonary hypertension?

Population

23 consecutive Japanese patients with pulmonary hypertension, mean age 55.3, 19 females / 4 males…

Design

Cross-sectional, Hemodynamic data were obtained by cardiologists independently…

Key result

3-dimensional echocardiography-derived diastolic and systolic remodeling indices significantly correlated with pulmonary vascular resistance (R=0.67, P=0.0005 and R=0.55, P=0.006, respectively).

Authors

TIToshiro InabaAYAtsushi YaoTNTomoko Nakao

Discussion

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Overview

Hypothesis-generating for non-invasive PVR surrogates in PH; leaves open prospective validation before clinical use.

Study Design

Type

Observational (n=23)

Structured PICO

Does 3-dimensional echocardiography accurately reflect invasive hemodynamic changes in patients with pulmonary hypertension?

P
Population
23 consecutive Japanese patients with pulmonary hypertension (PH), mean age 55.3, 19 females / 4 males. Etiologies included IPAH/HPAH (n=5), collagen disease (n=13), congenital (n=2), portal hypertension (n=2), and CTEPH (n=1).
I
Intervention
3-dimensional echocardiography (3DECHO) to measure right and left ventricular volumes and function, compared with right heart catheterization hemodynamics.
O
Outcome
Correlation between 3DECHO-derived ventricular volume indices (RVEDVI, RVESVI, LVEDVI, LVESVI, RVEF, remodeling indices) and invasive hemodynamic parameters (PVR, mPAP, mRAP)surrogate

Main Result

Effect estimate: R=0.67

p-value: p=0.0005

Novel 3D echocardiography indices, particularly the diastolic remodeling index (RVEDVI/LVEDVI), strongly correlate with invasive pulmonary vascular resistance and may serve as non-invasive indicators of hemodynamic severity in pulmonary hypertension.

Limitations

  • Small sample size
  • Poor detection of RV anterior wall and trabeculations in some subjects (general success rate ~85%)
  • Need for larger data to confirm linear relationships for each PH etiology

Cite This Study

Inaba et al. (2012) conducted an observational in Pulmonary hypertension (n=23). 3-dimensional echocardiography vs. Cardiac magnetic resonance imaging and right heart catheterization was evaluated on Correlation of diastolic remodeling index (RVEDVI/LVEDVI) with pulmonary vascular resistance (R=0.67, p=0.0005). 3-dimensional echocardiography-derived diastolic and systolic remodeling indices significantly correlated with pulmonary vascular resistance (R=0.67, P=0.0005 and R=0.55, P=0.006, respectively).

synapsesocial.com/papers/6a12b4127b4a43778303a290https://doi.org/10.1253/circj.cj-12-0203
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