title: Right isovolumic contraction velocity predicts survival in pulmonary hypertension.
abstract: BACKGROUND
  Right ventricular function is a strong determinant of prognosis in severe pulmonary hypertension.
  
  
  METHODS
  The aim of this study was to evaluate the prognostic value of estimates of right ventricular function obtained by echocardiography and Doppler tissue imaging and of functional class and 6-min walk distance (6MWD) in 142 patients with either pulmonary arterial hypertension (n = 104) or chronic thromboembolic pulmonary hypertension (n = 38). Echocardiography was prospectively performed, and demographics, medications, associated medical conditions, New York Heart Association class, and 6MWD at inclusion in addition to vital status, transplantation, and hospital admission related to pulmonary hypertension at follow-up were then collected by review of the medical records.
  
  
  RESULTS
  Variables associated with overall survival by univariate analysis were 6MWD (P = .009), functional class (P = .024), tricuspid annular plane systolic excursion (P = .03) and isovolumic peak velocity at the tricuspid annulus (IVCv) (P = .003). On multivariate analysis, IVCv (P = .015) and 6MWD (P = .016) were the only independent predictors of survival. Kaplan-Meier estimates of survival at 1 year were 95% in patients with IVCv > 9 cm/sec and 80% in those with IVCv ≤ 9 cm/sec (P = .002). Intraobserver and interobserver variability of IVCv measurement were 5% and 9%, respectively.
  
  
  CONCLUSIONS
  Measurement of right ventricular function by Doppler tissue imaging, an easy, noninvasive, and reproducible method, is an independent predictor of clinical outcomes in patients with severe pulmonary hypertension.
authors.affiliation: Explorations Fonctionnelles Cardiovasculaires, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Ernande
authors.forename: Vincent
authors.initials: V
authors.lastname: Cottin
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Leroux
authors.forename: Nicolas
authors.initials: N
authors.lastname: Girerd
authors.forename: Sandrine
authors.initials: S
authors.lastname: Huez
authors.forename: Aurélien
authors.initials: A
authors.lastname: Mulliez
authors.forename: Cyrille
authors.initials: C
authors.lastname: Bergerot
authors.forename: Michel
authors.initials: M
authors.lastname: Ovize
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Mornex
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Cordier
authors.forename: Robert
authors.initials: R
authors.lastname: Naeije
authors.forename: Geneviève
authors.initials: G
authors.lastname: Derumeaux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000401:mortality / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D015996:Survival Rate; D016278:Ventricular Function, Right; D016138:Walking / Q000502:physiology