Validation Study on the Accuracy of Echocardiographic Measurements of Right Ventricular Systolic Function in Pulmonary Hypertension

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概要

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• Background: Accuracy of echocardiographic parameters of right ventricular (RV) function has not been sufficiently validated in patients with pulmonary hypertension (PH). We attempted to evaluate whether echocardiographic measurements reliably reflect RV systolic function in PH using cardiac magnetic resonance imaging (CMRI)-derived RV ejection fraction (EF) as a gold standard. Materials and Methods: A total of thirty-seven consecutive patients with PH, 20 with pulmonary arterial hypertension, 12 with chronic thromboembolic pulmonary hypertension, and 5 others, were prospectively studied. All patients underwent echocardiography, CMRI and right heart catheterization within a 1-week interval. Associations between 5 echocardiography-derived parameters of RV systolic function and CMRI-derived RVEF were evaluated. Results: All 5 echocardiography-derived parameters were significantly correlated with CMRI-derived RVEF (%RV fractional shortening: r=0.48, p=0.0011; %RV area change: r=0.40, p=0.0083; tricuspid annular plane systolic excursion (TAPSE): r=0.86, p<0.0001, RV myocardial performance index: r=-0.59, p<0.0001; and systolic lateral tricuspid annular motion velocity (TVlat): r=0.63, p<0.0001). When compared with the other indices, TAPSE exhibited the highest correlation coefficient. Of the 5 echocardiographic measurements, only TAPSE significantly predicted CMRI-derived RVEF in multiple regression analysis (p<0.0001). Intra- and interobserver reproducibility was favorable for all 5 indices, and for TAPSE and TVlat was particularly high. Conclusion: Echocardiographic measurements are promising noninvasive indices of RV systolic function in patients with PH. In particular, TAPSE is superior to other indices in accuracy.

著者

• Ohira Hiroshi

  First Department Of Medicine Hokkaido University School Of Medicine

• Oyama Noriko

  Radiology Hokkaido University School Of Medicine

• Sakaue Shinji

  First Department Of Medicine Hokkaido University School Of Medicine

• Tsujino Ichizo

  First Department Of Medicine Hokkaido University School Of Medicine

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