Comparison of echocardiographic parameters to assess right ventricular function in pulmonary hypertension

Heart Vessels. 2017 Oct;32(10):1214-1219. doi: 10.1007/s00380-017-0991-6. Epub 2017 May 19.

Abstract

Although measurement of right ventricular ejection fraction (RVEF) may be relevant for evaluation of therapeutic efficacy and/or prognosis in patients with pulmonary hypertension, RVEF obtained by echocardiography has limited accuracy. In contrast, radionuclide and/or magnetic resonance imaging can measure RVEF more reliably. In this study, we investigated the relationship between RVEF measured by radionuclide angiography and the echocardiographic parameters that are recommended by the American Society of Echocardiography as representative of right heart function. There were 23 study participants with pulmonary hypertension who underwent radionuclide angiography and 2-dimensional and Doppler echocardiography (n = 30 measurements). RVEF measured by radionuclide angiography correlated with right ventricular Tei index (RV Tei index) measured by Doppler echocardiography (r = -0.601, P < 0.0005). Receiver operating characteristic curve analysis showed that an RV Tei index cut-off value of 0.371 was the best of predictor of RVEF ≤35% (area under the curve = 0.768, sensitivity = 0.857, selectivity = 0.667). Multiple regression analysis showed that RVEF was correlated with the RV Tei index, and this association was independent of other echocardiographic right ventricular function parameters (r = -0.644, P < 0.005). The RV Tei index measured by Doppler echocardiography may be an acceptable surrogate marker of RVEF in patients with pulmonary hypertension.

Keywords: Echocardiography; Pulmonary hypertension; Radionuclide angiography; Right ventricular Tei index; Right ventricular ejection fraction.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Echocardiography, Doppler*
  • Female
  • Heart Ventricles / diagnostic imaging*
  • Heart Ventricles / pathology
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging*
  • Hypertension, Pulmonary / physiopathology*
  • Male
  • Middle Aged
  • ROC Curve
  • Radionuclide Angiography
  • Regression Analysis
  • Severity of Illness Index
  • Stroke Volume
  • Vascular Resistance
  • Ventricular Dysfunction, Right / diagnostic imaging*