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RV Fractional Area Change and TAPSE as Predictors of Severe Right Ventricular Dysfunction in Pulmonary Hypertension: A CMR Study
Authors:Susana?Hoette,Nicolas?Creuzé,Sven?Günther,David?Montani,Laurent?Savale,Xavier?Ja?s,Florence?Parent,Olivier?Sitbon,Carlos?Eduardo?Rochitte,Gerald?Simonneau,Marc?Humbert,Rogerio?Souza  author-information"  >  author-information__contact u-icon-before"  >  mailto:souza.rogerio@me.com"   title="  souza.rogerio@me.com"   itemprop="  email"   data-track="  click"   data-track-action="  Email author"   data-track-label="  "  >Email author,Denis?Chemla
Affiliation:1.Pulmonary Department, Heart Institute,University of Sao Paulo Medical School,Sao Paulo,Brazil;2.Physiology and Radiology-EA4533,Faculté de Médecine Paris 11-APHP,Le Kremlin Bicêtre,France;3.Pneumology-APHP-Paris11 University-Inserm UMR_S999,Le Kremlin Bicêtre,France;4.Cardiovascular Imaging, Heart Institute,University of Sao Paulo Medical School,Sao Paulo,Brazil
Abstract:

Background

The right ventricular ejection fraction (RVEF) is a surrogate marker of right ventricular function in pulmonary hypertension (PH), but its measurement is complicated and time consuming. The tricuspid annular plane systolic excursion (TAPSE) measures only the longitudinal component of RV contraction while the right ventricular fractional area change (RVFAC) takes into account both the longitudinal and the transversal components. The aim of our study was to evaluate the relationship between RVEF, RVFAC, and TAPSE according to hemodynamic severity in two groups of patients with PH: pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH).

Methods and Results

Fifty-four patients with PAH (n?=?15) and CTEPH (n?=?39) underwent right heart catheterization and cardiac magnetic resonance (CMR). The ventricular volumes and areas, TAPSE, and eccentricity index were measured. The RVFAC was more strongly correlated with the RVEF (r?=?0.81, p?r?=?0.63, p?p?=?0.042). In the group with the worse hemodynamic status, the RVFAC correlated much better with the RVEF than the TAPSE. There were no significant differences in the CMR data analyzed between the groups of PAH and CETPH patients.

Conclusions

The RVFAC is a good index to estimate RVEF in PH patients; even better than the TAPSE in patients with more severe hemodynamic profile, possibly for including the transversal component of right ventricular function in its measurement. Furthermore, RVFAC performance was similar in the two PH groups (PAH and CTEPH).
Keywords:
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