Abstract 3625: Three Dimensional Echocardiography Provides New Indexes for the Evaluation of Pulmonary Hypertension
Introduction: Hemodynamic data are important to diagnose and take care of pulmonary hypertension (PH), but have been only available with an invasive cardiac catheterization. On the other hand, the non-invasive assessment of PH has been quite limited. Real-time three-dimensional echocardiography (RT3DE) provides volume data on right ventricle (RV) as well as left ventricle (LV), and therefore seems to be useful to evaluate right heart failure due to PH.
Objectives: Our purposes are to investigate whether the volume data by RT3DE match the hemodynamic data by right-heart catheterization, to propose noninvasive indexes to assume pulmonary vascular resistance (PVR), which indicates the severity of PH.
Methods: Thirteen PH patients were examined with right-heart catheterization and RT3DE.
Results: EDVI clearly showed dilated RV with compressed LV (80.7±19.5 and 54.3±11.0 ml/m2, respectively). The linear regression analysis revealed that not RV but LV stroke volume index (StVI) measured by RT3DE well matched StVI by Fick method (p=.0016, R=.783), implying the existence of TR. Since the other regurgitations were negligible, TR volume index (VI) was calculated with a formula of RVStVI-LVStVI, and positively correlated with RV end-diastolic volume index (EDVI) (p=.002, R=.77). RV ejection fraction (EF) by RT3DE was not correlated with PVR or RVEDVI, while functional RVEF newly termed by LVStVI (=RVStVI-TRVI)/RVEDVI had significantly negative correlation (p=.025, <.0001, R=−.62, −.89, respectively). RVEDVI and RV end-systolic VI (ESVI) were positively correlated with PVR (p=.045, .018, R=.56, .64, respectively), while LVEDVI and LVESVI were negatively correlated with PVR (p=.006, .0002, R=−.72, −.68, respectively). RVEDVI/LVEDVI and RVESVI/LVESVI (‘remodeling indexes’) were found to be more significantly correlated with PVR (p=.0016, .0009, R=.78, .80, respectively). Finally, the principal component analysis has revealed that two components (first one=−0.49 RVEDVI− 0.50RVESVI+0.53LVEDVI+0.47 LVESVI, and second one=0.51RVEDVI+0.49RVESVI+0.44LVEDVI+0.56LVESVI) could presume the value of PVR.
Conclusions: Our data suggest that the biventricular volume data by RT3DE provide useful new indexes to evaluate the severity of PH patients.