Abstract 727: Prognosis Value of Isovolumic Contraction Peak Velocity at the Tricuspid Annulus in Precapillary Pulmonary Hypertension
Background: Prognosis in patients (pts) with pulmonary hypertension (PH) is highly determined by right ventricular (RV) function. Aim: To evaluate the prognostic value of conventional echocardiographic and tissue Doppler imaging (TDI) indices of RV function in PH.
Methods: 159 pts (60±16 years) with precapillary PH (sPAP: 78±21mmHg, pulmonary arterial hypertension: 65.5%, chronic thrombo-embolic PH: 23.3%)were included. Precapillary PH was confirmed by right heart catheterization (mean PAP: 47±11mmHg, pulmonary vascular resistance: 12.6±5.8 WU). All pts underwent a standard echocardiography and a TDI study. The following RV function parameters were measured in apical 4-chamber view: tricuspid annular plane systolic excursion (TAPSE) using M-mode; peak velocity during isovolumic (IVCt) and ejection (St) phase and time of isovolumic relaxation (IVRT) using pulsed TDI at the tricuspid annulus; systolic longitudinal strain at the basal (SLbase), mid (SLmid), and apical (SLapex) segments of the RV free wall (SLmean: mean value of the 3 segments) using color TDI.
Results: During a mean follow-up of 12.2±9.6 months, 33 pts died. Clinical and echographic data are shown in table⇓. Among clinical and echocardiographic data, the following parameters were predictors of death at univariate analysis: 6′walk test, diastolic eccentricity index, right atrial area indexed by height, TAPSE, IVCt, St, IVRT, SLbase, SLmid, SLapex and SLmean(p<0.05 for all). At multivariate analysis (Cox regression method), 6′walk test <<26> 310 m (p = 0.03) and IVCt <<26> 9cm/s (p =0.005) were the only independant prognostic parameters.
Conclusion: The present study demonstrates the key role of RV contractility as assessed by IVCt to predict adverse outcomes in patients with PH.