Page 45 - Assessing right ventricular function and the pulmonary circulation in pulmonary hypertension Onno Anthonius Spruijt

Chapter 3
Figure 1: Representative Measures of Right Heart Size and Functional Parameters. A: Measures of right ventricular end-diastolic area (RVEDA). B: Measures of right ventricular end-systolic area (RVESA) and 2-dimensional tricuspid annular systolic excursion (TAPSE). C: Measures of tricuspid regurgitation (TR) duration. D: Measures of RV ejection time. RA = right atrial; RVET = right ventricular ejection time; RVFAC = right ventricular fractional area change; RVMPI = right ventricular myocardial performance index.
Reference values for right heart remodeling and function
RV systolic dysfunction was classified based on RVFAC as mild (25-35%), moderate (18-24%), or severe (≤17%) [11]. For indexed values of RA size and function, because no values are referenced in the ASE guidelines, we used 95% of the upper limit of 95 prospectively recruited age- and sex- matched healthy controls on the basis of a 50-point questionnaire. Dimensions were categorized using similar thresholds as the left atrial volumes: mild increase (increase <18% of reference value) and severe increase (increase >40% of reference value). For indexed RA area and right ventricular end-diastolic area (RVEDA), the upper limit of normal was 11 cm2/m2 and for indexed right ventricular end-systolic area (RVESA), the upper limit was 7.5 cm2/m2.
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