title: Analyses of longitudinal and of transverse right ventricular function provide different clinical information in patients with pulmonary hypertension.
abstract: We tested the hypothesis that analysis of longitudinal right ventricular (RV) function and analysis of transverse RV function by echocardiography provide different clinical information in patients with pulmonary hypertension (PH). Indices of longitudinal and transverse RV function were obtained with different echocardiographic techniques in 30 patients with idiopathic pulmonary arterial hypertension, 28 patients with systolic left ventricular dysfunction and PH (sLVD PH), 27 patients with sLVD and normal pulmonary pressure (sLVD no PH) undergoing right heart catheterization and 20 healthy patients. Indices of RV transverse function were significantly worse in patients with PH than in patients without PH and did not statistically differ between patients with normal and those with reduced cardiac index; RV diameter shortening at mid-segment correlated best with mean pulmonary artery pressure (h = 0.63, p < 0.001). Indices of longitudinal function were poorly related to severity of PH, but a tricuspid annular plane systolic excursion <15 mm predicted a cardiac index <2.5 L/min/m(2) with 80% sensitivity and 93% specificity (area under curve = 0.85). In conclusion, in patients with PH, reduced transverse RV function is a reliable indicator of the presence of high pulmonary artery pressure, whereas reduced RV longitudinal function is associated with impairment of cardiac function.
authors.affiliation: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pica
authors.affiliation: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: s.ghio@smatteo.pv.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ghio
authors.affiliation: Department of Cardiology, ASL L'Aquila, L'Aquila, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Tonti
authors.affiliation: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Camporotondo
authors.affiliation: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Turco
authors.affiliation: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Anna Sara
authors.initials: AS
authors.lastname: Pazzano
authors.affiliation: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Scelsi
authors.affiliation: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Raineri
authors.affiliation: Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Oltrona Visconti
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: Echocardiography; Pulmonary hypertension; Right ventricle