Abstract 17406: Three Dimensional Echocardiographic Wall Motion Tracking Assessment of Right Ventricular Remodeling and Effects on Left Ventricular Function as Prognostic Predictors in Patients With Pulmonary Hypertension
Introduction: Progression of pulmonary hypertension (PH) may cause right ventricular (RV) remodeling and variable effects on left ventricular (LV) remodeling and function. The prognostic significance of effects of RV remodeling on 3D LV deformation in patients with PH is still unknown.
Hypothesis: We hypothesized that 3D echocardiographic assessments of RV remodeling and LV stroke volume are of additive prognostic value in patients with PH.
Methods: We enrolled 115 patients with pre-capillary PH who were performed 3D echocardiography (Artida, Toshiba Corp.) using wall motion tracking and an invasive hemodynamic study. We calculated 3D LV and RV ejection fraction (EF), stroke volume (SV = LV End-Diastolic Volume - LV End-Systolic Volume). SV was indexed body surface area (SVI). Twenty-nine subjects were included as normal controls. We followed patients’ predefined outcome events for 6 months: death, lung transplantation.
Results: Of 115 patients with PH, 3D echo analysis was possible in 110 (96%). RVEF was significant lower than normal controls (33.4±9.4% vs. 51.5±3.8%, P<0.001). LV SVI was less than normal controls (41.1±6.8ml/m2 vs. 29.1±10.4 ml/m2). LV SVI was inversely correlated with invasive pulmonary vascular resistance (PVR) (r=-0.459, p<0.001). There were 36 PH patients (33%) with unfavorable clinical outcome events within 6 months. Baseline RVEF of < 31%, baseline LV SVI of < 24ml/m2 were associated with unfavorable outcomes [ Area Under Curve (AUC) 0.800, p<0.001 and AUC 0.736, p<0.001], respectively. Kaplan-Mayer analysis showed that the subgroup of patients with both low RVEF (< 31%) and low LV SVI (<24ml/m2) had the worst outcomes (Log rank p < 0.001).
Conclusions: Quantitative echo assessment of 3D RV remodeling and 3D LV stroke volume are markers for unfavorable outcomes in patients with pulmonary hypertension and have promise for clinical utility.
Author Disclosures: M. Sugahara: None. Z. Qi: None. S. Marc: None. M. Mathier: None. J. Gorcsan: Research Grant; Significant; Biotronik, GE, Medtronic, St. Jude Medical, Toshiba, Hitachi.
- © 2016 by American Heart Association, Inc.