Work

Regional longitudinal bi-ventricular function in pulmonary hypertension: single heart-beat assessment of strain by fast-senc imaging

Year: 2011

Type: article

Abstract: PH patients demonstrated reduced E LL at all RV levels compared to controls (Figure 1 ). On regional analysis, reduced E LL was noted in all segments (p<0.05) except the inferior and inferior septal insertion at all levels (Table 1 ). Reduced mean RV E LL correlated with elevated mPAP (r=0.6, p<0.001), pulmonary vascular resistance index (PVRI, r=0.8, p<0.001) as well as reduced RV systolic function parameters (p<0.05 for all) (Figure 2 ). In the LV, reduced E LL was mainly noted at the basal anterior (-16.7 vs. -20.5, p=0.03) and antero-septal regions (-12.8 vs. -18.2, p<0.01). Reduced LV antero-septal E LL correlated with increased mPAP (r=0.5, p<0.01), increased septal eccentricity index (r=0.5, p<0.01) and reduced RV systolic function (p<0.05 for all). On multiple linear regression including mPAP, RV end-diastolic volume index and RV mass index as covariates, mPAP was an independent predictor of reduced mean RV E LL (β=0.19, p<0.01). In turn, reduced mean RV E LL was the main predictor of reduced RVEF in PH patients (β=-1.2, p=0.03) in a model including mPAP, mean RV E LL and RV mass index. In PH patients with maintained global RV function, regional E LL was reduced at the basal and mid anterior septal insertions as well as mid anterior RV segments (p<0.05 for all). (A) Basal short axis fast-SENC peak systolic image in a 53 year old healthy female subject demonstrating normal longitudinal shortening (E LL ) (red color). (B) Basal short axis fast-SENC peak systolic image in a 47 year old female PH patient (mPAP = 51 mmHg). Note regionally reduced RV E LL and LV antero-septal E LL (white color). Probe points correspond to regions of interest where strain was measured. A mesh was used to measure LV E LL at six basal, six mid and four apical LV segments respectively. Figure 2 In PH patients, reduced RV E LL measured by fast-SENC is associated with increased afterload and correlates with biventricular global dysfunction. RV strain analysis using fast-SENC can detect subclinical regional dysfunction in absence of global RV functional compromise.

Source: Journal of Cardiovascular Magnetic Resonance

DOI: 10.1186/1532-429x-13-s1-p279