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Lung

, Volume 196, Issue 2, pp 157–164 | Cite as

RV Fractional Area Change and TAPSE as Predictors of Severe Right Ventricular Dysfunction in Pulmonary Hypertension: A CMR Study

  • Susana Hoette
  • Nicolas Creuzé
  • Sven Günther
  • David Montani
  • Laurent Savale
  • Xavier Jaïs
  • Florence Parent
  • Olivier Sitbon
  • Carlos Eduardo Rochitte
  • Gerald Simonneau
  • Marc Humbert
  • Rogerio Souza
  • Denis Chemla
Pulmonary Hypertension

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 < 0.0001) than the TAPSE (r = 0.63, p < 0.0001). RVEF < 35% was better predicted by the RVFAC than the TAPSE (TAPSE: AUC = 0.77 and RVFAC: AUC = 0.91; 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

Right ventricular dysfunction Pulmonary hypertension Cardiac ventricles Hemodynamics RVFAC TAPSE 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Susana Hoette
    • 1
  • Nicolas Creuzé
    • 2
  • Sven Günther
    • 3
  • David Montani
    • 3
  • Laurent Savale
    • 3
  • Xavier Jaïs
    • 3
  • Florence Parent
    • 3
  • Olivier Sitbon
    • 3
  • Carlos Eduardo Rochitte
    • 4
  • Gerald Simonneau
    • 3
  • Marc Humbert
    • 3
  • Rogerio Souza
    • 1
  • Denis Chemla
    • 2
  1. 1.Pulmonary Department, Heart InstituteUniversity of Sao Paulo Medical SchoolSao PauloBrazil
  2. 2.Physiology and Radiology-EA4533Faculté de Médecine Paris 11-APHPLe Kremlin BicêtreFrance
  3. 3.Pneumology-APHP-Paris11 University-Inserm UMR_S999Le Kremlin BicêtreFrance
  4. 4.Cardiovascular Imaging, Heart InstituteUniversity of Sao Paulo Medical SchoolSao PauloBrazil

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