title: Echocardiographic parameters in patients with pulmonary arterial hypertension: correlations with right ventricular ejection fraction derived from cardiac magnetic resonance and hemodynamics.
abstract: BACKGROUND
  Echocardiography is the most convenient method used to evaluate right ventricular function, and several echocardiographic parameters were studied in previous studies. But the value of these parameters to assess the right ventricular function in patients with pulmonary arterial hypertension (PAH) has not been well defined.
  
  
  METHODS
  Patients with PAH were observed prospectively. Right heart catheterization, echocardiography and cardiac magnetic resonance (CMR) were performed within 1 week interval. The correlations between echocardiographic parameters and right ventricular ejection fraction (RVEF) derived from CMR as well as hemodynamics were analyzed.
  
  
  RESULTS
  Thirty patients were enrolled including 24 with idiopathic PAH, 5 with PAH associated with connective tissue diseases and 1 with hereditary PAH. All echocardiographic parameters except right ventricular myocardial performance index (RVMPI) correlated significantly with RVEF (tricuspid annual plane systolic excursion [TAPSE], r = 0.440, P = 0.015; tricuspid annular systolic excursion velocity [S'], r = 0.444, P = 0.016; isovolumic acceleration [IVA], r = 0.600, P = 0.001; right ventricular fraction area change [RVFAC], r = 0.416, P = 0.022; ratio of right ventricular transverse diameter to left ventricular transverse diameter [RVETD/LVETD], r = -0.649, P<0.001; RVMPI, r = -0.027, P = 0.888). After adjusted for mean right atrial pressure, mean pulmonary arterial pressure and pulmonary vascular resistance (PVR), only IVA and RVETD/LVETD could independently predict RVEF. Four echocardiographic parameters displayed significant correlations with PVR (TAPSE, r = -0.615, P<0.001; S', r = -0.557, P = 0.002; RVFAC, r = -0.454, P = 0.012; RVETD/LVETD, r = 0.543, P = 0.002).
  
  
  CONCLUSIONS
  The echocardiographic parameters IVA and RVETD/LVETD can reflect RVEF independently regardless of hemodynamics in patients with PAH. In addition, TAPSE, S', RVFAC and RVETD/LVETD can also reflect PVR in PAH patients.
authors: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Tao
authors: T
authors: Yang
authors: Yu
authors: Y
authors: Liang
authors: Yan
authors: Y
authors: Zhang
authors: Qing
authors: Q
authors: Gu
authors: Guo
authors: G
authors: Chen
authors: Xin-Hai
authors: XH
authors: Ni
authors: Xiu-Zhang
authors: XZ
authors: Lv
authors: Zhi-Hong
authors: ZH
authors: Liu
authors: Chang-Ming
authors: CM
authors: Xiong
authors: Jian-Guo
authors: JG
authors: He
mesh_terms: D000328:Adult; D004562:Electrocardiography; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D015999:Multivariate Analysis; D013318:Stroke Volume; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*
references: Circulation. 2002 Apr 9;105(14):1693-9
references: 11940549
references: Cardiovasc Ultrasound. 2010 Jan 22;8:3
references: 20096122
references: Echocardiography. 2008 Mar;25(3):289-93
references: 18307442
references: Circ J. 2010 Feb;74(2):312-9
references: 20009388
references: Echocardiography. 2007 Jul;24(6):572-9
references: 17584196
references: Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7
references: 12091180
references: Heart. 2002 Sep;88(3):244-8
references: 12181215
references: Eur Heart J. 2009 Oct;30(20):2493-537
references: 19713419
references: JACC Cardiovasc Imaging. 2009 Feb;2(2):150-2
references: 19356548
references: Eur J Echocardiogr. 2010 Sep;11(8):719-24
references: 20410189
references: Am J Cardiol. 2012 Mar 15;109(6):906-13
references: 22196780
references: Eur J Echocardiogr. 2007 Oct;8(5):317-21
references: 16846757
references: Int J Cardiol. 2006 Oct 26;113(1):25-33
references: 16325940
references: Am Heart J. 1984 Mar;107(3):526-31
references: 6695697
references: J Cardiovasc Magn Reson. 2010 Jun 04;12:35
references: 20525337
references: Int J Cardiol. 2011 Aug 18;151(1):58-62
references: 20537415
references: J Am Soc Echocardiogr. 1996 Nov-Dec;9(6):838-47
references: 8943444
references: J Am Soc Echocardiogr. 2009 Apr;22(4):361-8
references: 19345305
references: J Am Soc Echocardiogr. 2007 Sep;20(9):1058-64
references: 17555927
references: Eur Heart J. 2007 May;28(10):1250-7
references: 17242010
references: J Magn Reson Imaging. 2008 Jul;28(1):67-73
references: 18581357
references: Chin Med J (Engl). 2011 Jun;124(11):1672-7
references: 21740775
references: J Magn Reson Imaging. 2010 Jan;31(1):117-24
references: 20027579
references: Chest. 2008 Feb;133(2):358-62
references: 17951624
references: J Am Soc Echocardiogr. 2012 Mar;25(3):280-6
references: 22230250
references: J Am Coll Cardiol. 2011 Dec 6;58(24):2511-9
references: 22133851