Abstract 9491: Prognostic Implications of Right Ventricular Longitudinal Peak Systolic Strain on Long-Term Outcome in Patients with Pulmonary Hypertension
Purpose: The performance of the right ventricle (RV) is an important prognostic marker in patients with pulmonary hypertension (PH). Two-dimensional speckle tracking strain analysis allows angle independent evaluation of RV systolic function. The aim of this study was to assess the prognostic value of RV longitudinal peak systolic strain (LPSS) on the long-term survival in patients with pulmonary hypertension of all aetiologies.
Methods: One-hundred fifty patients with PH of all aetiologies (age 59±15 yrs; NYHA 2.56±0.68; mean systolic artery pressure 62±20 mmHg) were analyzed. RV LPSS was assessed by 2-dimensional speckle tracking echocardiography at baseline. All cause mortality was noted during follow-up.
Results: During a mean follow-up of 2.7±1.8 years, 37 (26%) patients had died. The study population was divided according to the value of -19% RV LPSS. Both groups of patients were comparable in terms of age, gender, LV ejection fraction, WHO PH group and systolic artery pressure. Patients with RV LPSS ≥ -19% had significant lower TAPSE (16±4 mm vs. 18±4 mm, p<0.001), RV FAC (32±13% vs 37±9%, p=0.027), larger RV diastolic area (23±7 vs. 20±5, p=0.008) and worse NYHA functional class (2.7±0.6 vs. 2.3±0.8, p=0.003). Kaplan-Meier curve demonstrated a significant worse survival in patients with RV LPSS ≥ -19% (figure 1, log-rank p=0.002). After multivariate correction, RV LPSS ≥ -19% was significantly associated to all-cause mortality (HR 3.36, 95% CI 1.13-9.96, p=0.029).
Conclusions: RV LPSS is associated with long-term survival of patients with pulmonary hypertension of all aetiologies. RV LPSS may be a valuable parameter to risk stratify these patients.
- © 2011 by American Heart Association, Inc.