Clinical InvestigationRight Ventricular Function–Influences of Changes in LoadingValidation Study on the Accuracy of Echocardiographic Measurements of Right Ventricular Systolic Function in Pulmonary Hypertension
Section snippets
Methods
Patients with PH were prospectively enrolled between April 2010 and February 2011. A mean pulmonary artery pressure ≥ 25 mm Hg and pulmonary wedge pressure ≤ 15 mm Hg evaluated by right-heart catheterization (RHC) were used as entry criteria.1 Exclusion criteria were (1) inability to obtain or analyze images from CMRI or echocardiography for any reason, (2) comorbid left-heart diseases that may affect RV geometry and function, and (3) signs or symptoms indicative of an unstable condition of PH.
Results
A total of 39 patients met the entry criteria during the study period, but two were excluded because of prespecified exclusion criteria (inability to undergo CMRI because of claustrophobia in one patient and hypertrophic cardiomyopathy in another). Clinical characteristics and CMRI and RHC measurements of the 37 patients with PH are summarized in Table 1. Bland-Altman analysis of CMRI-derived RVEF showed high agreement for both intraobserver and interobserver reproducibility (mean ± limits of
Discussion
The present study demonstrated that echocardiographic measurements of RV systolic function were significantly correlated with CMRI-derived RVEF in patients with PH. In particular, TAPSE exhibited the strongest independent correlation with RVEF, with sufficient reproducibility. To the best of our knowledge, this study is the first to systematically validate the accuracy of echocardiographic indices of RV systolic function in patients with PH using CMRI as a gold standard.
A significant
Conclusions
This study demonstrated that echocardiographic measurements are promising noninvasive indices of RV systolic function in patients with PH. In particular, TAPSE is superior to other indices in accuracy. Optimal application of these indices is expected to enable more accurate assessment of cardiac function and thus better management of patients with PH.
Acknowledgments
We are thankful to Dr. Daisuke Ikeda and to Dr. Megumu Ohira for planning the study protocol and interpretation of the obtained data.
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