TY - JOUR
T1 - Right heart size and function significantly correlate in patients with pulmonary arterial hypertension - A cross-sectional study 11 Medical and Health Sciences 1102 Cardiorespiratory Medicine and Haematology
AU - Fischer, Lukas
AU - Benjamin, Nicola
AU - Blank, Norbert
AU - Egenlauf, Benjamin
AU - Fischer, Christine
AU - Harutyunova, Satenik
AU - Koegler, Maria
AU - Lorenz, Hanns Martin
AU - Marra, Alberto M.
AU - Nagel, Christian
AU - Xanthouli, Panagiota
AU - Bossone, Eduardo
AU - Grünig, Ekkehard
PY - 2018/11/8
Y1 - 2018/11/8
N2 - Background: The objective of this study was to assess, whether right atrial (RA) and ventricular (RV) size is related to RV pump function at rest and during exercise in patients with pulmonary arterial hypertension (PAH). Methods: We included 54 patients with invasively diagnosed PAH that had been stable on targeted medication. All patients underwent clinical assessments including right heart catheterization and echocardiography at rest and during exercise. RV output reserve was defined as increase of cardiac index (CI) from rest to peak exercise (ΔCIexercise). Patients were classified according to the median of RA and RV-area. RV pump function and further clinical parameters were compared between groups by student's t-test. Uni- and multivariate Pearson correlation analyses were performed. Results: Patients with larger RA and/or RV-areas (above a median of 16 and 20cm2, respectively) showed significantly lower ΔCIexercise, higher mean pulmonary arterial pressure, pulmonary vascular resistance at rest and NT-proBNP levels. Furthermore, patients with higher RV-areas presented with a significantly lower RV stroke volume and pulmonary arterial compliance at peak exercise than patients with smaller RV-size. RV area was identified as the only independent predictor of RV output reserve. Conclusion: RV and RA areas represent valuable and easily accessible indicators of RV pump function at rest and during exercise. Cardiac output reserve should be considered as an important clinical parameter. Prospective studies are needed for further evaluation.
AB - Background: The objective of this study was to assess, whether right atrial (RA) and ventricular (RV) size is related to RV pump function at rest and during exercise in patients with pulmonary arterial hypertension (PAH). Methods: We included 54 patients with invasively diagnosed PAH that had been stable on targeted medication. All patients underwent clinical assessments including right heart catheterization and echocardiography at rest and during exercise. RV output reserve was defined as increase of cardiac index (CI) from rest to peak exercise (ΔCIexercise). Patients were classified according to the median of RA and RV-area. RV pump function and further clinical parameters were compared between groups by student's t-test. Uni- and multivariate Pearson correlation analyses were performed. Results: Patients with larger RA and/or RV-areas (above a median of 16 and 20cm2, respectively) showed significantly lower ΔCIexercise, higher mean pulmonary arterial pressure, pulmonary vascular resistance at rest and NT-proBNP levels. Furthermore, patients with higher RV-areas presented with a significantly lower RV stroke volume and pulmonary arterial compliance at peak exercise than patients with smaller RV-size. RV area was identified as the only independent predictor of RV output reserve. Conclusion: RV and RA areas represent valuable and easily accessible indicators of RV pump function at rest and during exercise. Cardiac output reserve should be considered as an important clinical parameter. Prospective studies are needed for further evaluation.
KW - Pulmonary hypertension
KW - Pump function
KW - Right atrial size
KW - Right ventricular output reserve
KW - Right ventricular size
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U2 - 10.1186/s12931-018-0913-x
DO - 10.1186/s12931-018-0913-x
M3 - Article
C2 - 30409145
AN - SCOPUS:85056254945
VL - 19
JO - Respiratory Research
JF - Respiratory Research
SN - 1465-9921
IS - 1
M1 - 216
ER -