Right ventricular outflow tract spectral signal: a useful marker of right ventricular systolic performance and pulmonary hypertension severity.
OBJECTIVE
Right ventricular outflow tract (RVOT) acceleration shortens with chronic pulmonary hypertension (cPH). However, the overall value of this spectral Doppler signal in the assessment of PH patients is not well understood.


RESULTS
Markers of RV systolic performance, time to onset, time to peak, and total duration of the RVOT systolic spectral Doppler signal were examined. Group I consisted of 28 patients without PH [50 +/- 15 years and mean pulmonary artery systolic pressure (PASP) of 30 +/- 8 mmHg] and Group II included 52 patients with cPH (56 +/- 14 years and mean PASP of 80 +/- 27 mmHg; P < 0.0001). As expected, Group II patient's markers showed worse RV performance. In addition, Group II had a longer time to onset, a shorter time to peak, and a shorter total duration of the RVOT systolic signal than Group I. Both time to onset (r = 0.66 vs. r = -0.53; P < 0.0001) and time to peak (r = 0.65 vs. r = 0.50; P < 0.0001) of the RVOT signal correlated better with PH than RV fractional area change. Conversely, RV fractional area change correlated better with total duration of RVOT ejection (r = 0.66 vs. r = 0.58; P < 0.0001) than with PASP.


CONCLUSIONS
Timing of onset and peak of the RVOT systolic spectral signal appears to be useful in characterizing the severity of the PASP, while the total duration of RVOT ejection is a better predictor of the systolic performance of the RV in PH patients. More studies are now required to determine the clinical utility of prospectively measuring RVOT in cPH.
Lopez-Candales
Angel
A
Cardiovascular Institute, University of Pittsburgh Medical Center, Scaife 560, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA. lopezcandalesa@upmc.edu
Eleswarapu
Ananth
A
Shaver
James
J
Edelman
Kathy
K
Gulyasy
Beth
B
Candales
Maria Dolores
MD
D015415:Biomarkers; D004452:Echocardiography / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012044:Regression Analysis; D012720:Severity of Illness Index; D013223:Statistics as Topic; D013997:Time Factors; D016278:Ventricular Function, Right
D015415:Biomarkers