TY - JOUR
T1 - Clinical application of tissue Doppler imaging in patients with idiopathic pulmonary hypertension
AU - Ruan, Qinyun
AU - Nagueh, Sherif
PY - 2007/1/1
Y1 - 2007/1/1
N2 - Background: Tissue Doppler (TD) echocardiographic imaging of mitral and tricuspid annulus has been applied to assess right ventricular (RV) and left ventricular (LV) function in many cardiac diseases, but its clinical application, including response to long-term targeted therapy in patients with idiopathic pulmonary hypertension (PH), has not been addressed. Methods: Seventy patients with idiopathic PH were compared with 35 age-matched control subjects to examine myocardial velocities by TD. Of these, 35 patients underwent repeat imaging after long-term targeted therapy. In addition, 50 consecutive patients with idiopathic PH with simultaneous right-heart catheterization and echocardiography were examined. Results: No significant differences were noted between PH patients and the control group in lateral mitral annulus systole velocity and early diastolic velocity (Ea) by TD, but septal velocities were significantly lower (p < 0.01). With targeted therapy, myocardial velocities at the septum and RV free wall increased significantly (p < 0.05). Likewise, E/Ea ratio increased, albeit still in the normal range. In all 50 patients with invasive measurements, lateral E/Ea ratio readily identified normal mean pulmonary capillary wedge pressure (PCWP). Conclusions: TD imaging of the lateral mitral annules can reliably predict the presence of normal/reduced mean PCWP in patients with idiopathic PH, and track the improvement in RV function and LV filling with-long-term targeted therapy.
AB - Background: Tissue Doppler (TD) echocardiographic imaging of mitral and tricuspid annulus has been applied to assess right ventricular (RV) and left ventricular (LV) function in many cardiac diseases, but its clinical application, including response to long-term targeted therapy in patients with idiopathic pulmonary hypertension (PH), has not been addressed. Methods: Seventy patients with idiopathic PH were compared with 35 age-matched control subjects to examine myocardial velocities by TD. Of these, 35 patients underwent repeat imaging after long-term targeted therapy. In addition, 50 consecutive patients with idiopathic PH with simultaneous right-heart catheterization and echocardiography were examined. Results: No significant differences were noted between PH patients and the control group in lateral mitral annulus systole velocity and early diastolic velocity (Ea) by TD, but septal velocities were significantly lower (p < 0.01). With targeted therapy, myocardial velocities at the septum and RV free wall increased significantly (p < 0.05). Likewise, E/Ea ratio increased, albeit still in the normal range. In all 50 patients with invasive measurements, lateral E/Ea ratio readily identified normal mean pulmonary capillary wedge pressure (PCWP). Conclusions: TD imaging of the lateral mitral annules can reliably predict the presence of normal/reduced mean PCWP in patients with idiopathic PH, and track the improvement in RV function and LV filling with-long-term targeted therapy.
KW - Idiopathic pulmonary hypertension
KW - Tissue Doppler imaging
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U2 - 10.1378/chest.06-1556
DO - 10.1378/chest.06-1556
M3 - Article
C2 - 17296639
AN - SCOPUS:33847148607
VL - 131
SP - 395
EP - 401
JO - CHEST
JF - CHEST
SN - 0012-3692
IS - 2
ER -