PMID- 21900188
OWN - NLM
STAT- MEDLINE
DCOM- 20120111
LR  - 20131121
IS  - 1941-3297 (Electronic)
IS  - 1941-3289 (Linking)
VI  - 4
IP  - 6
DP  - 2011 Nov
TI  - Right ventricular failure in idiopathic pulmonary arterial hypertension is 
      associated with inefficient myocardial oxygen utilization.
PG  - 700-6
LID - 10.1161/CIRCHEARTFAILURE.111.962381 [doi]
AB  - BACKGROUND: In idiopathic pulmonary arterial hypertension (IPAH), increased right 
      ventricular (RV) power is required to maintain cardiac output. For this, RV O2 
      consumption (MVO2) must increase by augmentation of O2 supply and/or improvement 
      of mechanical efficiency-ratio of power output to MVO2. In IPAH with overt RV 
      failure, however, there is evidence that O2 supply (perfusion) reserve is 
      reduced, leaving only increase in either O2 extraction or mechanical efficiency 
      as compensatory mechanisms. We related RV mechanical efficiency to clinical and 
      hemodynamic parameters of RV function in patients with IPAH and associated it 
      with glucose metabolism. METHODS AND RESULTS: The patients included were in New 
      York Heart Association (NYHA) class II (n=8) and class III (n=8). They underwent 
      right heart catheterization, MRI, and H2(15)O-, (15)O2-, C(15)O-, and 18FDG-PET. 
      RV power and O2 supply were similar in both groups (NYHA class II versus class 
      III: 0.54+/-0.14 versus 0.47+/-0.12 J/s and 0.109+/-0.022 versus 0.128+/-0.026 mL O2/min 
      per gram, respectively). RV O2 extraction was near-significantly lower in NYHA 
      class II compared with NYHA class III (63+/-17% versus 75+/-16%, respectively, 
      P=0.10). As a result, MVO2 was significantly lower (0.066+/-0.012 versus 
      0.092+/-0.010 mL O2/min per gram, respectively, P=0.006). RV efficiency was reduced 
      in NYHA class III (13.9+/-3.8%) compared with NYHA class II (27.8+/-7.6%, P=0.001). 
      Septal bowing, measured by MRI, correlated with RV efficiency (r = -0.59, 
      P=0.020). No relation was found between RV efficiency and glucose uptake rate. RV 
      mechanical efficiency and ejection fraction were closely related (r=0.81, 
      P<0.001). CONCLUSIONS: RV failure in IPAH was associated with reduced mechanical 
      efficiency that was partially explained by RV mechanical dysfunction but not by a 
      metabolic shift.
FAU - Wong, Yeun Ying
AU  - Wong YY
AD  - Department of Pulmonology, Institute for Cardiovascular Research, VU University 
      Medical Center, Amsterdam, The Netherlands.
FAU - Ruiter, Gerrina
AU  - Ruiter G
FAU - Lubberink, Mark
AU  - Lubberink M
FAU - Raijmakers, Pieter G
AU  - Raijmakers PG
FAU - Knaapen, Paul
AU  - Knaapen P
FAU - Marcus, J Tim
AU  - Marcus JT
FAU - Boonstra, Anco
AU  - Boonstra A
FAU - Lammertsma, Adriaan A
AU  - Lammertsma AA
FAU - Westerhof, Nico
AU  - Westerhof N
FAU - van der Laarse, Willem J
AU  - van der Laarse WJ
FAU - Vonk-Noordegraaf, Anton
AU  - Vonk-Noordegraaf A
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110907
PL  - United States
TA  - Circ Heart Fail
JT  - Circulation. Heart failure
JID - 101479941
RN  - IY9XDZ35W2 (Glucose)
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - Adult
MH  - Cardiac Catheterization
MH  - Cardiac Output/physiology
MH  - Comorbidity
MH  - Female
MH  - Glucose/metabolism
MH  - Heart Ventricles/*physiopathology
MH  - Humans
MH  - Hypertension, Pulmonary/classification/*epidemiology/*metabolism
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*metabolism
MH  - New York
MH  - Oxygen/*metabolism
MH  - Positron-Emission Tomography
MH  - Severity of Illness Index
MH  - Stroke Volume/physiology
MH  - Ventricular Dysfunction, Right/classification/*epidemiology/*metabolism
EDAT- 2011/09/09 06:00
MHDA- 2012/01/12 06:00
CRDT- 2011/09/09 06:00
PHST- 2011/09/09 06:00 [entrez]
PHST- 2011/09/09 06:00 [pubmed]
PHST- 2012/01/12 06:00 [medline]
AID - CIRCHEARTFAILURE.111.962381 [pii]
AID - 10.1161/CIRCHEARTFAILURE.111.962381 [doi]
PST - ppublish
SO  - Circ Heart Fail. 2011 Nov;4(6):700-6. doi: 10.1161/CIRCHEARTFAILURE.111.962381. 
      Epub 2011 Sep 7.