Abstract 12826: Systolic Velocity of the Tricuspid Annulus Decreases After Pulmonary Thromboendarterectomy in Patients With Chronic Thromboembolic Pulmonary Hypertension
Introduction: Echocardiographic assessment of RV function is problematic. Systolic velocity of the tricuspid annulus (tSm) has been shown to correlate with RV ejection fraction. Furthermore, tSmis generally depressed in chronic pulmonary hypertension. We sought to evaluate RV systolic function in chronic thromboembolic pulmonary hypertension (CTEPH) using 2D speckle tracking before and after pulmonary thromboendarterectomy (PTE).
Hypothesis: We hypothesized that tSm would increase after PTE.
Methods: We measured tSm from 2D echocardiography using speckle tracking in 127 consecutive CTEPH patients (52 ± 14 years, 49% female) with adequate images pre- & post- PTE. tSm was measured 9.7 ± 17.3 days before and 11.3 ± 17.0 days after PTE using Epsilon Imaging EchoInsight software.
Results: Unexpectedly, tSm worsened after PTE (8.2 ± 3.5 to 5.4 ± 2.8 cm/sec [p=<0.0001]). Pulmonary vascular resistance (PVR), mean pulmonary artery pressure (mPAP), and cardiac output (CO) all improved: 723 ± 258 to 246 ± 133 dyne-sec/cm5 (p=<0.0001), 46 ± 12 to 24 ± 7 mm Hg (p=<0.0001), and 4.4 ± 1.3 to 5.6 ± 1.2 L/min (p=<0.0001) respectively after PTE (Table 2). Preoperatively, tSmcorrelated inversely with PVR (p=<0.0001) and mPAP (p=0.003) and directly with CO (p=0.0002) (Table 1). Postoperatively, tSmdid not significantly correlate with PVR, mPAP, or CO.
Conclusions: tSmcorrelates significantly with PVR, mPAP, and CO in patients referred for CTEPH. Early after PTE, however, tSmdecreases by 34% and demonstrates no correlation with postoperative right heart catheterization data. In conclusion, tSmcannot be used to accurately predict RV function immediately following successful PTE.
Author Disclosures: D. Wong: None. O. Yousefian: None. W. Auger: None. T. Dittrich: None. M. Madani: None. L. Daniels: None. A. Raisinghani: None. A. DeMaria: None. D. Blanchard: None.
- © 2015 by American Heart Association, Inc.