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Altered synchrony of right ventricular contraction in borderline pulmonary hypertension

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Abstract

Imaging studies have shown that pulmonary hypertension (PH) is associated with inhomogenous right ventricular (RV) regional contraction, or dyssynchrony, and that this is of prognostic relevance. This study aimed at the identification and functional significance of RV dyssynchrony in borderline PH defined by a mean pulmonary artery pressure between (mPAP) 20 and 25 mmHg. RV dyssynchrony was measured by 2-dimensional speckle tracking echocardiography in 17 patients with pulmonary arterial hypertension (PAH), 13 patients with borderline PH and 14 controls. Dyssynchrony was defined as the R-R interval-corrected standard deviation of the times to peak-systolic strain for the basal and medium segments of the RV. All the PH patients underwent a right heart catheterization. RV dyssynchrony amounted to 69 ± 34 ms in PAH, 47 ± 23 ms in borderline PH and 8 ± 6 ms in controls, all different from each other (p < 0.05). RV dyssynchrony in borderline PH was the only parameter of RV systolic dysfunction in 11 of 13 (85%) of the patients. RV dyssynchrony was accompanied by postsystolic shortening and correlated to RV fractional area change, not to mPAP or pulmonary vascular resistance. RV dyssynchrony occurs in borderline PH and may reflect early RV-arterial uncoupling.

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Acknowledgements

The authors thank nurses of pulmonary hypertension referral center for the expert technical assistance, the entire University of Rouen Hospital, le Havre hospital echocardiography laboratory staff.

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Authors and Affiliations

  1. Department of Pulmonology and Respiratory Critical Care, Pulmonary hypertension competence center, Normandie Univ, UNIROUEN, EA 3830, Institute for Research and Innovation in Biomedicine (IRIB), Rouen University Hospital, 76000, Rouen, France

    Bouchra Lamia, Jean-François Muir & Antoine Cuvelier

  2. Department of Pulmonology, Le Havre Hospital Complexe, BP 84, 76083, Le Havre Cedex, France

    Bouchra Lamia & Jean Quieffin

  3. Department of Cardiology, Le Havre Hospital Complexe, BP 84, 76083, Le Havre Cedex, France

    Bouchra Lamia & Philippe Bonnet

  4. Department of Pulmonology and Respiratory Critical Care, Rouen University Hospital, 76000, Rouen, France

    Luis-Carlos Molano & Catherine Viacroze

  5. Department of Biostatistics, Normandie Univ, UNIROUEN, Rouen University Hospital, 76000, Rouen, France

    Jacques Benichou

  6. Department of Physiology, Faculty of Medicine, Free University of Medicine, Brussels, Belgium

    Robert Naeije

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  1. Bouchra Lamia
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  2. Jean-François Muir
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  3. Luis-Carlos Molano
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  4. Catherine Viacroze
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  5. Jacques Benichou
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  7. Jean Quieffin
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  8. Antoine Cuvelier
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  9. Robert Naeije
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Correspondence to Bouchra Lamia.

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Ethics in this article is approved by the Humans Research Ethics Commitee (HREC).

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Bouchra Lamia and Robert Naeije take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

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Lamia, B., Muir, JF., Molano, LC. et al. Altered synchrony of right ventricular contraction in borderline pulmonary hypertension. Int J Cardiovasc Imaging 33, 1331–1339 (2017). https://doi.org/10.1007/s10554-017-1110-6

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  • DOI: https://doi.org/10.1007/s10554-017-1110-6

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