Page 82 - Assessing right ventricular function and the pulmonary circulation in pulmonary hypertension Onno Anthonius Spruijt

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Triple combination therapy (ERA + PDE5I + prostacyclin)
Post-PTE
Hemodynamic characteristics
Heart rate (beats/min)
Mean pulmonary artery pressure (mmHg) Pulmonary arterial wedge pressure (mmHg) Mean right atrial pressure (mmHg) Pulmonary vascular resistance (dyn.s/cm5) Cardiac output (l/min)
Mixed venous O2 saturation (%)
8 2
78 ± 14 48 ± 15 10 ± 3
9 ± 6 607 ± 398 5,6 ± 1,9 65 ± 11
Table 1: Clinical characteristics, treatment and hemodynamics. M = males; F = females; BMI = Body Mass Index; BSA = Body Surface Area; NYHA = New York Heart Association functional class; 6MWD = six minute walk distance; CTEPH = Chronic Thromboembolic Pulmonary Hypertension; ERA = Endothelin Receptor Antagonists; PDE5I = Phosphodiesterase-5 Inhibitors.
Parameters
CMRI-RVEF (%)
Fractional area change (%)
Tricuspid annular plane systolic excursion (mm) Longitudinal movements
Tricuspid annulus-apex ED (mm) Tricuspid annulus-apex ES (mm) Tricuspid annulus-apex distance (mm) Fractional longitudinal wall motion (%)
Transverse movements
Septum to free wall ED (mm) Septum to free wall ES (mm)
Septum to free wall distance (mm) Fractional transverse wall motion (%)
Mean ± SD
41.4 ± 15.2 35.8 ± 11.4 18.8 ± 4
92.4 ± 13.7 75.8 ± 12.4 11.8 ± 9.5 17.6 ± 6.8
41.2 ± 11.1 30.9 ± 11 8.6 ± 6 23.7 ± 11.1
Table 2: Right ventricular function. CMRI-RVEF = Right Ventricle Ejection Fraction derived from cardiac magnetic resonance imaging; RVFAC = right ventricular fractional area change; TAPSE = tricuspid annular plane systolic excursion; ED = end-diastole; ES = end-systole.
In the cohort of 96 patients, mean time between CMRI and echo was 2±2 days. CMRI-derived-RVEF correlated significantly to all echo parameters (figure 2). The strongest relation was seen between CMRI-derived-RVEF and RVFAC (r2=0.567, P<0.001), while weaker correlations exist between RVEF