Right Ventricular Strain for Prediction of Survival in Patients With Pulmonary Arterial Hypertension
Background Pulmonary arterial hypertension (PAH) is a devastating illness of pulmonary vascular remodeling, right-sided heart failure, and limited survival. Whether strain-based measures of right ventricular (RV) systolic function predict future right-sided heart failure and/or death is untested. Me...
Gespeichert in:
| Veröffentlicht in: | Chest 2011-06, Vol.139 (6), p.1299-1309 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1309 |
|---|---|
| container_issue | 6 |
| container_start_page | 1299 |
| container_title | Chest |
| container_volume | 139 |
| creator | Sachdev, Arun, MD Villarraga, Hector R., MD Frantz, Robert P., MD McGoon, Michael D., MD, FCCP Hsiao, Ju-Feng, MD Maalouf, Joseph F., MD Ammash, Naser M., MD McCully, Robert B., MD Miller, Fletcher A., MD Pellikka, Patricia A., MD Oh, Jae K., MD Kane, Garvan C., MD, PhD, FCCP |
| description | Background Pulmonary arterial hypertension (PAH) is a devastating illness of pulmonary vascular remodeling, right-sided heart failure, and limited survival. Whether strain-based measures of right ventricular (RV) systolic function predict future right-sided heart failure and/or death is untested. Methods RV longitudinal systolic strain and strain rate were evaluated by echocardiography in 80 patients with World Health Organization group 1 pulmonary hypertension (PH) (72% were functional class [FC] III or IV). Survival status was assessed over 4 years. Results All patients had a depressed RV systolic strain (−15% ± 5%) and strain rate (−0.80 ± 0.29 s−1 ). Of the parameters assessed, average RV free wall systolic strain worse than −12.5% identified a cohort with greater severity of disease (82% were FC III/IV), greater RV systolic dysfunction (RV stroke volume index 26 ± 9 mL/m2 ), and higher right atrial pressure (12 ± 5 mm Hg). Patients with an RV free wall strain worse than −12.5% were associated with a greater degree of disease progression within 6 months, a greater requirement for loop diuretics, and/or a greater degree of lower extremity edema, and it also predicted 1-, 2-, 3-, and 4-year mortality (unadjusted 1-year hazard ratio, 6.2; 2.1–22.3). After adjusting for age, sex, PH cause, and FC, patients had a 2.9-fold higher rate of death per 5% absolute decline in RV free wall strain at 1 year. Conclusions Noninvasive assessment of RV longitudinal systolic strain and strain rate independently predicts future right-sided heart failure, clinical deterioration, and mortality in patients with PAH. |
| doi_str_mv | 10.1378/chest.10-2015 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_871379464</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0012369211602857</els_id><sourcerecordid>871379464</sourcerecordid><originalsourceid>FETCH-LOGICAL-c377t-b338f560cff8a841f2bef133dbe12f4bca11a13b30ebcc8acf24bb4c31244c33</originalsourceid><addsrcrecordid>eNpFkUFvEzEQRi0EoqHlyBX5gjht8djOrnNBqqpCkSo1aio4WrZjE5eNN9jeSPn3zJJAL7ZHft9o9IaQd8AuQXTqk9v4Ui-BNZzB_AWZwUJAI-ZSvCQzxoA3ol3wM_KmlCeGNSza1-SMA0jFJczI-iH-3FT63aeaoxt7k-mqZhMTDUOmy-zX0dU4JDoEuhrzPu5NT_F3aWrETKE_Yt3Q5dhvh2TygV7l6nNE5vaw8_hOBcMX5FUwffFvT_c5efxy83h929zdf_12fXXXONF1tbFCqDBvmQtBGSUhcOsDCLG2HniQ1hkAA8IK5q1zyrjApbXSCeAST3FOPh7b7vLwe0QtehuL831vkh_GolWHxhaylUg2R9LloZTsg97luMX5NTA9adV_tU7VpBX596fOo9369X_6n0cEPpwAU5zpQzbJxfLMSSQVTCN-PnIeNeyjz9r1MUWM_PIHX56GMSc0pEEXrpleTRucFgjQMq7mnfgDtlCXvQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>871379464</pqid></control><display><type>article</type><title>Right Ventricular Strain for Prediction of Survival in Patients With Pulmonary Arterial Hypertension</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><source>Journals@Ovid Complete</source><creator>Sachdev, Arun, MD ; Villarraga, Hector R., MD ; Frantz, Robert P., MD ; McGoon, Michael D., MD, FCCP ; Hsiao, Ju-Feng, MD ; Maalouf, Joseph F., MD ; Ammash, Naser M., MD ; McCully, Robert B., MD ; Miller, Fletcher A., MD ; Pellikka, Patricia A., MD ; Oh, Jae K., MD ; Kane, Garvan C., MD, PhD, FCCP</creator><creatorcontrib>Sachdev, Arun, MD ; Villarraga, Hector R., MD ; Frantz, Robert P., MD ; McGoon, Michael D., MD, FCCP ; Hsiao, Ju-Feng, MD ; Maalouf, Joseph F., MD ; Ammash, Naser M., MD ; McCully, Robert B., MD ; Miller, Fletcher A., MD ; Pellikka, Patricia A., MD ; Oh, Jae K., MD ; Kane, Garvan C., MD, PhD, FCCP</creatorcontrib><description>Background Pulmonary arterial hypertension (PAH) is a devastating illness of pulmonary vascular remodeling, right-sided heart failure, and limited survival. Whether strain-based measures of right ventricular (RV) systolic function predict future right-sided heart failure and/or death is untested. Methods RV longitudinal systolic strain and strain rate were evaluated by echocardiography in 80 patients with World Health Organization group 1 pulmonary hypertension (PH) (72% were functional class [FC] III or IV). Survival status was assessed over 4 years. Results All patients had a depressed RV systolic strain (−15% ± 5%) and strain rate (−0.80 ± 0.29 s−1 ). Of the parameters assessed, average RV free wall systolic strain worse than −12.5% identified a cohort with greater severity of disease (82% were FC III/IV), greater RV systolic dysfunction (RV stroke volume index 26 ± 9 mL/m2 ), and higher right atrial pressure (12 ± 5 mm Hg). Patients with an RV free wall strain worse than −12.5% were associated with a greater degree of disease progression within 6 months, a greater requirement for loop diuretics, and/or a greater degree of lower extremity edema, and it also predicted 1-, 2-, 3-, and 4-year mortality (unadjusted 1-year hazard ratio, 6.2; 2.1–22.3). After adjusting for age, sex, PH cause, and FC, patients had a 2.9-fold higher rate of death per 5% absolute decline in RV free wall strain at 1 year. Conclusions Noninvasive assessment of RV longitudinal systolic strain and strain rate independently predicts future right-sided heart failure, clinical deterioration, and mortality in patients with PAH.</description><identifier>ISSN: 0012-3692</identifier><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1378/chest.10-2015</identifier><identifier>PMID: 21148241</identifier><identifier>CODEN: CHETBF</identifier><language>eng</language><publisher>Northbrook, IL: American College of Chest Physicians</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Cardiology. Vascular system ; Cohort Studies ; Familial Primary Pulmonary Hypertension ; Female ; Heart Failure - etiology ; Humans ; Hypertension, Pulmonary - complications ; Hypertension, Pulmonary - mortality ; Hypertension, Pulmonary - physiopathology ; Male ; Medical sciences ; Middle Aged ; Pneumology ; Predictive Value of Tests ; Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases ; Pulmonary/Respiratory ; Stroke Volume ; Survival Rate ; Ultrasonography ; Ventricular Dysfunction, Right - complications ; Ventricular Dysfunction, Right - diagnostic imaging ; Ventricular Dysfunction, Right - mortality ; Ventricular Pressure - physiology</subject><ispartof>Chest, 2011-06, Vol.139 (6), p.1299-1309</ispartof><rights>The American College of Chest Physicians</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c377t-b338f560cff8a841f2bef133dbe12f4bca11a13b30ebcc8acf24bb4c31244c33</citedby><cites>FETCH-LOGICAL-c377t-b338f560cff8a841f2bef133dbe12f4bca11a13b30ebcc8acf24bb4c31244c33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24211813$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21148241$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sachdev, Arun, MD</creatorcontrib><creatorcontrib>Villarraga, Hector R., MD</creatorcontrib><creatorcontrib>Frantz, Robert P., MD</creatorcontrib><creatorcontrib>McGoon, Michael D., MD, FCCP</creatorcontrib><creatorcontrib>Hsiao, Ju-Feng, MD</creatorcontrib><creatorcontrib>Maalouf, Joseph F., MD</creatorcontrib><creatorcontrib>Ammash, Naser M., MD</creatorcontrib><creatorcontrib>McCully, Robert B., MD</creatorcontrib><creatorcontrib>Miller, Fletcher A., MD</creatorcontrib><creatorcontrib>Pellikka, Patricia A., MD</creatorcontrib><creatorcontrib>Oh, Jae K., MD</creatorcontrib><creatorcontrib>Kane, Garvan C., MD, PhD, FCCP</creatorcontrib><title>Right Ventricular Strain for Prediction of Survival in Patients With Pulmonary Arterial Hypertension</title><title>Chest</title><addtitle>Chest</addtitle><description>Background Pulmonary arterial hypertension (PAH) is a devastating illness of pulmonary vascular remodeling, right-sided heart failure, and limited survival. Whether strain-based measures of right ventricular (RV) systolic function predict future right-sided heart failure and/or death is untested. Methods RV longitudinal systolic strain and strain rate were evaluated by echocardiography in 80 patients with World Health Organization group 1 pulmonary hypertension (PH) (72% were functional class [FC] III or IV). Survival status was assessed over 4 years. Results All patients had a depressed RV systolic strain (−15% ± 5%) and strain rate (−0.80 ± 0.29 s−1 ). Of the parameters assessed, average RV free wall systolic strain worse than −12.5% identified a cohort with greater severity of disease (82% were FC III/IV), greater RV systolic dysfunction (RV stroke volume index 26 ± 9 mL/m2 ), and higher right atrial pressure (12 ± 5 mm Hg). Patients with an RV free wall strain worse than −12.5% were associated with a greater degree of disease progression within 6 months, a greater requirement for loop diuretics, and/or a greater degree of lower extremity edema, and it also predicted 1-, 2-, 3-, and 4-year mortality (unadjusted 1-year hazard ratio, 6.2; 2.1–22.3). After adjusting for age, sex, PH cause, and FC, patients had a 2.9-fold higher rate of death per 5% absolute decline in RV free wall strain at 1 year. Conclusions Noninvasive assessment of RV longitudinal systolic strain and strain rate independently predicts future right-sided heart failure, clinical deterioration, and mortality in patients with PAH.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Cohort Studies</subject><subject>Familial Primary Pulmonary Hypertension</subject><subject>Female</subject><subject>Heart Failure - etiology</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - complications</subject><subject>Hypertension, Pulmonary - mortality</subject><subject>Hypertension, Pulmonary - physiopathology</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pneumology</subject><subject>Predictive Value of Tests</subject><subject>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</subject><subject>Pulmonary/Respiratory</subject><subject>Stroke Volume</subject><subject>Survival Rate</subject><subject>Ultrasonography</subject><subject>Ventricular Dysfunction, Right - complications</subject><subject>Ventricular Dysfunction, Right - diagnostic imaging</subject><subject>Ventricular Dysfunction, Right - mortality</subject><subject>Ventricular Pressure - physiology</subject><issn>0012-3692</issn><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkUFvEzEQRi0EoqHlyBX5gjht8djOrnNBqqpCkSo1aio4WrZjE5eNN9jeSPn3zJJAL7ZHft9o9IaQd8AuQXTqk9v4Ui-BNZzB_AWZwUJAI-ZSvCQzxoA3ol3wM_KmlCeGNSza1-SMA0jFJczI-iH-3FT63aeaoxt7k-mqZhMTDUOmy-zX0dU4JDoEuhrzPu5NT_F3aWrETKE_Yt3Q5dhvh2TygV7l6nNE5vaw8_hOBcMX5FUwffFvT_c5efxy83h929zdf_12fXXXONF1tbFCqDBvmQtBGSUhcOsDCLG2HniQ1hkAA8IK5q1zyrjApbXSCeAST3FOPh7b7vLwe0QtehuL831vkh_GolWHxhaylUg2R9LloZTsg97luMX5NTA9adV_tU7VpBX596fOo9369X_6n0cEPpwAU5zpQzbJxfLMSSQVTCN-PnIeNeyjz9r1MUWM_PIHX56GMSc0pEEXrpleTRucFgjQMq7mnfgDtlCXvQ</recordid><startdate>20110601</startdate><enddate>20110601</enddate><creator>Sachdev, Arun, MD</creator><creator>Villarraga, Hector R., MD</creator><creator>Frantz, Robert P., MD</creator><creator>McGoon, Michael D., MD, FCCP</creator><creator>Hsiao, Ju-Feng, MD</creator><creator>Maalouf, Joseph F., MD</creator><creator>Ammash, Naser M., MD</creator><creator>McCully, Robert B., MD</creator><creator>Miller, Fletcher A., MD</creator><creator>Pellikka, Patricia A., MD</creator><creator>Oh, Jae K., MD</creator><creator>Kane, Garvan C., MD, PhD, FCCP</creator><general>American College of Chest Physicians</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110601</creationdate><title>Right Ventricular Strain for Prediction of Survival in Patients With Pulmonary Arterial Hypertension</title><author>Sachdev, Arun, MD ; Villarraga, Hector R., MD ; Frantz, Robert P., MD ; McGoon, Michael D., MD, FCCP ; Hsiao, Ju-Feng, MD ; Maalouf, Joseph F., MD ; Ammash, Naser M., MD ; McCully, Robert B., MD ; Miller, Fletcher A., MD ; Pellikka, Patricia A., MD ; Oh, Jae K., MD ; Kane, Garvan C., MD, PhD, FCCP</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c377t-b338f560cff8a841f2bef133dbe12f4bca11a13b30ebcc8acf24bb4c31244c33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Cohort Studies</topic><topic>Familial Primary Pulmonary Hypertension</topic><topic>Female</topic><topic>Heart Failure - etiology</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - complications</topic><topic>Hypertension, Pulmonary - mortality</topic><topic>Hypertension, Pulmonary - physiopathology</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pneumology</topic><topic>Predictive Value of Tests</topic><topic>Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases</topic><topic>Pulmonary/Respiratory</topic><topic>Stroke Volume</topic><topic>Survival Rate</topic><topic>Ultrasonography</topic><topic>Ventricular Dysfunction, Right - complications</topic><topic>Ventricular Dysfunction, Right - diagnostic imaging</topic><topic>Ventricular Dysfunction, Right - mortality</topic><topic>Ventricular Pressure - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sachdev, Arun, MD</creatorcontrib><creatorcontrib>Villarraga, Hector R., MD</creatorcontrib><creatorcontrib>Frantz, Robert P., MD</creatorcontrib><creatorcontrib>McGoon, Michael D., MD, FCCP</creatorcontrib><creatorcontrib>Hsiao, Ju-Feng, MD</creatorcontrib><creatorcontrib>Maalouf, Joseph F., MD</creatorcontrib><creatorcontrib>Ammash, Naser M., MD</creatorcontrib><creatorcontrib>McCully, Robert B., MD</creatorcontrib><creatorcontrib>Miller, Fletcher A., MD</creatorcontrib><creatorcontrib>Pellikka, Patricia A., MD</creatorcontrib><creatorcontrib>Oh, Jae K., MD</creatorcontrib><creatorcontrib>Kane, Garvan C., MD, PhD, FCCP</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sachdev, Arun, MD</au><au>Villarraga, Hector R., MD</au><au>Frantz, Robert P., MD</au><au>McGoon, Michael D., MD, FCCP</au><au>Hsiao, Ju-Feng, MD</au><au>Maalouf, Joseph F., MD</au><au>Ammash, Naser M., MD</au><au>McCully, Robert B., MD</au><au>Miller, Fletcher A., MD</au><au>Pellikka, Patricia A., MD</au><au>Oh, Jae K., MD</au><au>Kane, Garvan C., MD, PhD, FCCP</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Right Ventricular Strain for Prediction of Survival in Patients With Pulmonary Arterial Hypertension</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2011-06-01</date><risdate>2011</risdate><volume>139</volume><issue>6</issue><spage>1299</spage><epage>1309</epage><pages>1299-1309</pages><issn>0012-3692</issn><eissn>1931-3543</eissn><coden>CHETBF</coden><abstract>Background Pulmonary arterial hypertension (PAH) is a devastating illness of pulmonary vascular remodeling, right-sided heart failure, and limited survival. Whether strain-based measures of right ventricular (RV) systolic function predict future right-sided heart failure and/or death is untested. Methods RV longitudinal systolic strain and strain rate were evaluated by echocardiography in 80 patients with World Health Organization group 1 pulmonary hypertension (PH) (72% were functional class [FC] III or IV). Survival status was assessed over 4 years. Results All patients had a depressed RV systolic strain (−15% ± 5%) and strain rate (−0.80 ± 0.29 s−1 ). Of the parameters assessed, average RV free wall systolic strain worse than −12.5% identified a cohort with greater severity of disease (82% were FC III/IV), greater RV systolic dysfunction (RV stroke volume index 26 ± 9 mL/m2 ), and higher right atrial pressure (12 ± 5 mm Hg). Patients with an RV free wall strain worse than −12.5% were associated with a greater degree of disease progression within 6 months, a greater requirement for loop diuretics, and/or a greater degree of lower extremity edema, and it also predicted 1-, 2-, 3-, and 4-year mortality (unadjusted 1-year hazard ratio, 6.2; 2.1–22.3). After adjusting for age, sex, PH cause, and FC, patients had a 2.9-fold higher rate of death per 5% absolute decline in RV free wall strain at 1 year. Conclusions Noninvasive assessment of RV longitudinal systolic strain and strain rate independently predicts future right-sided heart failure, clinical deterioration, and mortality in patients with PAH.</abstract><cop>Northbrook, IL</cop><pub>American College of Chest Physicians</pub><pmid>21148241</pmid><doi>10.1378/chest.10-2015</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0012-3692 |
| ispartof | Chest, 2011-06, Vol.139 (6), p.1299-1309 |
| issn | 0012-3692 1931-3543 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_871379464 |
| source | MEDLINE; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Adult Aged Biological and medical sciences Cardiology. Vascular system Cohort Studies Familial Primary Pulmonary Hypertension Female Heart Failure - etiology Humans Hypertension, Pulmonary - complications Hypertension, Pulmonary - mortality Hypertension, Pulmonary - physiopathology Male Medical sciences Middle Aged Pneumology Predictive Value of Tests Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases Pulmonary/Respiratory Stroke Volume Survival Rate Ultrasonography Ventricular Dysfunction, Right - complications Ventricular Dysfunction, Right - diagnostic imaging Ventricular Dysfunction, Right - mortality Ventricular Pressure - physiology |
| title | Right Ventricular Strain for Prediction of Survival in Patients With Pulmonary Arterial Hypertension |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T23%3A42%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Right%20Ventricular%20Strain%20for%20Prediction%20of%20Survival%20in%20Patients%20With%20Pulmonary%20Arterial%20Hypertension&rft.jtitle=Chest&rft.au=Sachdev,%20Arun,%20MD&rft.date=2011-06-01&rft.volume=139&rft.issue=6&rft.spage=1299&rft.epage=1309&rft.pages=1299-1309&rft.issn=0012-3692&rft.eissn=1931-3543&rft.coden=CHETBF&rft_id=info:doi/10.1378/chest.10-2015&rft_dat=%3Cproquest_cross%3E871379464%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=871379464&rft_id=info:pmid/21148241&rft_els_id=1_s2_0_S0012369211602857&rfr_iscdi=true |