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Poyraz E, Can F, Keles N, Asarcikli LD, Sekerci SS, Gurkan TB, Dayı SU. Evaluation of right ventricular mechanics using exercise echocardiography in asymptomatic patients with severe mitral stenosis. THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 2024:10.1007/s10554-024-03263-z. [PMID: 39455512 DOI: 10.1007/s10554-024-03263-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 10/11/2024] [Indexed: 10/28/2024]
Abstract
We aimed to evaluate the effect of exercise echocardiography (EE) on Right ventricular (RV) deformation parameters in asymptomatic patients with severe rheumatic mitral stenosis (MS) (mitral valve area ≤ 1.5 cm2, stage C) and to determine the relation between symptoms and severity of MS. 38 rheumatic MS patients in stage C underwent EE. 20 Patients were defined; as an exercise intolerance group who couldn't reach a maximum heart rate according to their age during exercise due to developing dyspnea The remaining 18 patients who reached a maximum heart rate without dyspnea were defined; as an exercise tolerance group. RV echocardiographic parameters at baseline and peak exercise were compared between the groups. While RV global strain (RV GLS) (21.02 ± 3.33 vs. 21.92 ± 3.03) and RV free wall longitudinal strain (RV FWLS) (23.41 ± 5.66 vs. 25.08 ± 5.00) at baseline were similar in both groups (P = 0.390 P = 0.343), RV GLS (23.38 ± 4.30 vs. 26.05 ± 3.24) and RV FWLS (24.24 ± 5.78 vs. 28.05 ± 4.62) at peak exercise were reduced in exercise intolerance group (P = 0.040 P = 0.033). The best correlations were found between exercise capacity and RV FWLS at baseline and peak exercise in all MS patients (respectively; r = 0.627 P < 0.001; r = 0.697 P < 0.001). RV mechanics has approved the reliability of EE in patients with asymptomatic patients with severe MS. During exercise RV contractile reserve could diminish in MS patients with stage C who develop dyspnea. Moreover, since our study has a close relationship between exercise capacity and RV mechanics, using RV mechanics during exercise echocardiography may be useful for risk stratification in MS patients with severe MS.
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Affiliation(s)
- Esra Poyraz
- Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Department of Cardiology, Health Science University, Istanbul, Turkey.
| | - Fatma Can
- Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Department of Cardiology, Health Science University, Istanbul, Turkey
| | - Nursen Keles
- Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Department of Cardiology, Health Science University, Istanbul, Turkey
| | - Lale Dinc Asarcikli
- Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Department of Cardiology, Health Science University, Istanbul, Turkey
| | - Sena Sert Sekerci
- Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Department of Cardiology, Health Science University, Istanbul, Turkey
| | - Tulay Bayram Gurkan
- Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Department of Cardiology, Health Science University, Istanbul, Turkey
| | - Sennur Unal Dayı
- Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center, Department of Cardiology, Health Science University, Istanbul, Turkey
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Zhang Z, Li G, Gao Y, Zhou S, Xie J, Liu S, Zhao Z, Zhu C, Ordovas K, Pohost GM, Sun K, Li K. Healthy Adult Left and Right Ventricular Torsion and Torsion Rates With MR-Feature Tracking. J Magn Reson Imaging 2024; 60:1591-1601. [PMID: 38156373 DOI: 10.1002/jmri.29201] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/11/2023] [Accepted: 12/11/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND The clinical value of myocardial torsion quantification in prognostic assessment and risk stratification of various cardiovascular diseases is gradually being recognized. However, normal values of left and right ventricular (LV and RV) torsion and torsion rates (TRs) have not been fully determined, and their correlation with age and gender has not been well studied. PURPOSE To establish normal ranges of biventricular torsion, peak systolic and diastolic TRs using magnetic resonance feature tracking (MR-FT) technique based on a large sample of healthy adults, and further investigate their relationship with age and gender. STUDY TYPE Retrospective. POPULATION 566 Healthy adults (312 males, aged 43 ± 10 years; 254 females, aged 43 ± 11 years). FIELD STRENGTH/SEQUENCE 1.5T/gradient echo. ASSESSMENT Biventricular torsion, peak systolic, and diastolic TRs. STATISTICAL TESTS Shapiro-Wilk test, Student's t-test, Mann-Whitney-U test, linear regression, intraclass correlation coefficient, Bland-Altman analysis. Differences were regarded as statistically significant at P < 0.05. RESULTS Women demonstrated greater magnitudes of left ventricle (LV) torsion (1.23 ± 0.44 vs. 1.00 ± 0.42°/cm), peak systolic TR (9.69 ± 3.70 vs. 8.27 ± 3.73°/cm*sec), peak diastolic TR (-7.78 ± 2.82 vs. -6.06 ± 2.44°/cm*sec), and RV torsion (2.20 ± 1.23 vs. 1.65 ± 1.11°/cm*sec), peak systolic TR (16.07 ± 8.18 vs. 12.62 ± 7.08°/cm*sec), peak diastolic TR (-15.39 ± 6.53 vs. -11.70 ± 6.03°/cm*sec). For both genders, the magnitudes of LV and RV torsion, peak systolic, and diastolic TRs increased linearly with age. All the measurements of biventricular torsion, peak systolic and diastolic TRs achieved good to excellent intraobserver and interobserver reproducibility, with all intraclass correlation coefficients >0.70. DATA CONCLUSION The present study systematically provided age- and sex-stratified reference values for LV and RV torsion and TRs using MR-FT technique. Women and aging are associated with greater magnitudes of biventricular torsion, peak systolic, and diastolic TRs. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Zhen Zhang
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Gengxiao Li
- Department of Radiology, Shenzhen Second People's Hospital, Shenzhen, China
| | - Yiyuan Gao
- The First School of Clinical Medicine of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Shanshan Zhou
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Jianan Xie
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Shurong Liu
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Zhiwei Zhao
- Zhouxin Medical Imaging and Health Screening Center, Xiamen, Fujian, China
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Karen Ordovas
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Gerald M Pohost
- Zhouxin Medical Imaging and Health Screening Center, Xiamen, Fujian, China
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Kai Sun
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
| | - Kuncheng Li
- Department of Radiology, Medical imaging research institute of Longgang, the Third People's Hospital of Longgang District, Shenzhen, China
- Zhouxin Medical Imaging and Health Screening Center, Xiamen, Fujian, China
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
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Nazzetta DC, de Sousa LCG, Rosa VEE, Tessari FC, Campos CM, Lopes MAAM, Jardim CVP, Mapa LG, Lipari LFVP, Lopes MP, Fernandes JRC, de Santis A, Pires LJNT, Sampaio RO, Tarasoutchi F. Influence of Right Atrial Pressure on the Prognosis of Patients with Rheumatic Mitral Stenosis Undergoing Percutaneous Mitral Balloon Valvuloplasty. Diagnostics (Basel) 2024; 14:2079. [PMID: 39335758 PMCID: PMC11431111 DOI: 10.3390/diagnostics14182079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Revised: 08/31/2024] [Accepted: 09/08/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Pulmonary hypertension (PH) often complicates mitral stenosis (MS). The prognostic impact of pulmonary vascular resistance (PVR) in MS patients remains unclear. Previous study has demonstrated the prognostic impact of right atrial pressure (RAP) in patients with primary PH. We aim to determine the prognostic impact of PVR and RAP in patients with rheumatic MS undergoing percutaneous mitral balloon valvuloplasty (PMBV). METHODS A total of 58 patients with symptomatic severe rheumatic MS who underwent PMBV between 2016 and 2020 were included. Patients were divided into two groups: PVR ≤ 2WU (N = 26) and PVR > 2WU (N = 32). The composite endpoint included death, reintervention or persistent NYHA functional class III-IV during follow-up. RESULTS The median age was 50 (42-60) years, with 82.8% being female. Median pulmonary artery systolic pressure (PASP) was 42 (35-50.5) mmHg. Patients with PVR ≤ 2WU had lower PASP on both echocardiogram and catheterization. The PMBV success rate was 75.9%. Multivariate analysis, adjusted for PVR, showed RAP as the only independent predictor of the composite endpoint (HR:1.507, 95% CI:1.015-2.237, p = 0.042). The optimal RAP cutoff was 9.5 mmHg (HR:3.481, 95% CI:1.041-11.641; p = 0.043). CONCLUSIONS RAP was an independent predictor of adverse outcomes in patients with rheumatic MS undergoing PMBV, while PVR did not show prognostic significance. These findings suggest that the prognostic value of PVR may be lower than expected.
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Affiliation(s)
- Daniella Cian Nazzetta
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | - Larissa Christine Gomes de Sousa
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | - Vitor Emer Egypto Rosa
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | - Fernanda Castiglioni Tessari
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | - Carlos M Campos
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | | | - Carlos Viana Poyares Jardim
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | - Luís Gustavo Mapa
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | | | - Mariana Pezzute Lopes
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | - João Ricardo Cordeiro Fernandes
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | - Antonio de Santis
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | - Lucas José Neves Tachotti Pires
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | - Roney Orismar Sampaio
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
| | - Flávio Tarasoutchi
- Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo 05403-900, SP, Brazil
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Ahmad A, Li H, Zhang Y, Liu J, Gao Y, Qian M, Lin Y, Yi L, Zhang L, Li Y, Xie M. Three-Dimensional Echocardiography Assessment of Right Ventricular Volumes and Function: Technological Perspective and Clinical Application. Diagnostics (Basel) 2022; 12:806. [PMID: 35453854 PMCID: PMC9031180 DOI: 10.3390/diagnostics12040806] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/12/2022] [Accepted: 03/15/2022] [Indexed: 12/10/2022] Open
Abstract
Right ventricular (RV) function has important prognostic value in a variety of cardiovascular diseases. Due to complex anatomy and mode of contractility, conventional two-dimensional echocardiography does not provide sufficient and accurate RV function assessment. Currently, three-dimensional echocardiography (3DE) allows for an excellent and reproducible assessment of RV function owing to overcoming these limitations of traditional echocardiography. This review focused on 3DE and discussed the following points: (i) acquisition of RV dataset for 3DE images, (ii) reliability, feasibility, and reproducibility of RV volumes and function measured by 3DE with different modalities, (iii) the clinical application of 3DE for RV function quantification.
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Affiliation(s)
- Ashfaq Ahmad
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - He Li
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yanting Zhang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Juanjuan Liu
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Ying Gao
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Mingzhu Qian
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yixia Lin
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Luyang Yi
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Li Zhang
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
- Shenzhen Huazhong University of Science and Technology Research Institute, Shenzhen 518057, China
| | - Yuman Li
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Mingxing Xie
- Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (A.A.); (H.L.); (Y.Z.); (J.L.); (Y.G.); (M.Q.); (Y.L.); (L.Y.); (L.Z.)
- Clinical Research Center for Medical Imaging in Hubei Province, Wuhan 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China
- Shenzhen Huazhong University of Science and Technology Research Institute, Shenzhen 518057, China
- Tongji Medical College and Wuhan National Laboratory for Optoelectronics, Huazhong University of Science and Technology, Wuhan 430022, China
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