PMID- 25201651
OWN - NLM
STAT- MEDLINE
DCOM- 20150910
LR  - 20201216
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Linking)
VI  - 15
IP  - 12
DP  - 2014 Dec
TI  - Clinical value of echocardiographic Doppler-derived right ventricular dp/dt in 
      patients with pulmonary arterial hypertension.
PG  - 1411-9
LID - 10.1093/ehjci/jeu134 [doi]
AB  - AIMS: Right ventricular (RV) dp/dt is the instantaneous rate of RV pressure rise 
      during early systole and is a surrogate marker of RV contractility. The main 
      objective of this study was to evaluate the ability of echocardiographic Doppler 
      obtained RV dp/dt to predict long-term survival in patients with pulmonary 
      arterial hypertension (PAH) and chronic thrombo-embolic pulmonary hypertension 
      (CTEPH). METHODS AND RESULTS: Seventy-eight consecutive newly diagnosed untreated 
      patients (64 +/- 15 years, 71% female, 57% PAH, 43% inoperable CTEPH) were included 
      in the study. At baseline, patients were assessed clinically [New York Heart 
      Association (NYHA) and 6 minutes walking distance (6MWD)], by transthoracic 
      cardiac ultrasound and by right heart catherization. RV dp/dt was assessed using 
      spectral Doppler recordings from the tricuspid regurgitation signal at a sweep 
      speed of 200 mm/s by measuring the time interval in which the regurgitant 
      velocity increased from 0.5 to 2 m/s. During a mean follow-up period of 3.5 +/- 1.7 
      years, 31 patients died and 3 received a lung transplant [study endpoint reached 
      in 34/78 (44%) patients]. The optimal RV dp/dt cut-off was determined by receiver 
      operating characteristic analysis at 3 years to be 410 mmHg/s (specificity 84%, 
      positive-predictive value 55%, and negative-predictive value 83%). In univariate 
      analysis, RV dp/dt <410 mmHg/s (hazard ratio 2.67, 95% CI 1.30-5.47, P = 0.007), 
      tricuspid annulus plane systolic excursion (TAPSE) <15 mm, NYHA, 6MWD, and right 
      atrial pressure were predictors of mortality. In a multivariate model with TAPSE, 
      RV dp/dt remained an independent predictor of mortality (P = 0.01). CONCLUSION: A 
      reduced baseline RV dp/dt is a clear indicator of poor outcome independent of 
      TAPSE in patients with PAH/CTEPH.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author 2014. For permissions please email: journals.permissions@oup.com.
FAU - Ameloot, Koen
AU  - Ameloot K
AD  - Department of Cardiovascular Diseases, Medical Imaging Research Center, 
      University Hospitals Leuven, Leuven, Belgium koen.ameloot@uzleuven.be.
FAU - Palmers, Pieter-Jan
AU  - Palmers PJ
AD  - Department of Cardiovascular Diseases, Medical Imaging Research Center, 
      University Hospitals Leuven, Leuven, Belgium.
FAU - Vande Bruaene, Alexander
AU  - Vande Bruaene A
AD  - Department of Cardiovascular Diseases, Medical Imaging Research Center, 
      University Hospitals Leuven, Leuven, Belgium.
FAU - Gerits, Annelies
AU  - Gerits A
AD  - Department of Cardiovascular Diseases, Medical Imaging Research Center, 
      University Hospitals Leuven, Leuven, Belgium.
FAU - Budts, Werner
AU  - Budts W
AD  - Department of Cardiovascular Diseases, Medical Imaging Research Center, 
      University Hospitals Leuven, Leuven, Belgium.
FAU - Voigt, Jens-Uwe
AU  - Voigt JU
AD  - Department of Cardiovascular Diseases, Medical Imaging Research Center, 
      University Hospitals Leuven, Leuven, Belgium.
FAU - Delcroix, Marion
AU  - Delcroix M
AD  - Respiratory Division, University Hospitals Leuven, Leuven, Belgium.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140908
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Catheterization/methods
MH  - Echocardiography/methods
MH  - Echocardiography, Doppler/*methods
MH  - Exercise Test
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Ventricles/*diagnostic imaging
MH  - Humans
MH  - Hypertension, Pulmonary/*diagnostic imaging/mortality
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Retrospective Studies
MH  - Sensitivity and Specificity
MH  - Survival Analysis
MH  - Walking
OTO - NOTNLM
OT  - Pulmonary hypertension
OT  - Right ventricular function
EDAT- 2014/09/10 06:00
MHDA- 2015/09/12 06:00
CRDT- 2014/09/10 06:00
PHST- 2014/09/10 06:00 [entrez]
PHST- 2014/09/10 06:00 [pubmed]
PHST- 2015/09/12 06:00 [medline]
AID - jeu134 [pii]
AID - 10.1093/ehjci/jeu134 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2014 Dec;15(12):1411-9. doi: 
      10.1093/ehjci/jeu134. Epub 2014 Sep 8.