title: Echocardiographic assessment of right ventricular contractile reserve in patients with pulmonary hypertension.
abstract: OBJECTIVE
  Right ventricular function is a major determinant of prognosis in pulmonary hypertension. The aim of this study was to assess and compare right ventricular contractile reserve in healthy subjects (controls) and in subjects with pulmonary hypertension (cases).
  
  
  METHODS
  In this prospective study of seven cases and seven controls undergoing treadmill stress echocardiography, right ventricular S-wave velocity, tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC) and stroke volume index were assessed at rest and with exercise. The increase in each parameter between rest and exercise for cases and controls was analyzed and the magnitude of change in each parameter with exercise between cases and controls was compared.
  
  
  RESULTS
  A significant increase in S-wave velocity was observed in cases (rest: 9.4 ± 3.1; exercise: 13.7 ± 4.8 cm/s [p < 0.05]). In controls there was a statistically significant increase in S-wave velocity (12.9 ± 2.3 to 23.0 ± 7.2 cm/s [p < 0.005]), TAPSE (25.7 ± 2.4 to 31.0 ± 3.5 mm [p < 0.05]) and RVFAC (53.8 ± 14.7% to 64.4 ± 9.9% [p < 0.005]). The magnitude of change in S-wave velocity (cases: 4.3 ± 3.3; controls: 10.1 ± 5.5 cm/s [p < 0.05]), TAPSE (cases: 0.6 ± 2.5; controls: 5.3 ± 3.8 mm [p < 0.05]) and RVFAC (cases: -0.4 ± 11.8; controls: 10.6 ± 5.9% [p < 0.05]) was significantly different between cases and controls.
  
  
  CONCLUSIONS
  S-wave velocity, TAPSE and RVFAC increased significantly with exercise in controls. S-wave velocity was the only parameter that showed a significant increase in cases, although the magnitude of this increase was significantly less than in controls.
authors.affiliation: Serviço de Cardiologia do Hospital Garcia de Orta, Almada, Portugal. Electronic address: anaalmeida31@gmail.com.
authors.forename: Ana Rita
authors.initials: AR
authors.lastname: Almeida
authors.affiliation: Serviço de Cardiologia do Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Maria José
authors.initials: MJ
authors.lastname: Loureiro
authors.affiliation: Serviço de Cardiologia do Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Liliana
authors.initials: L
authors.lastname: Lopes
authors.affiliation: Serviço de Cardiologia do Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Carlos
authors.initials: C
authors.lastname: Cotrim
authors.affiliation: Serviço de Cardiologia do Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Lopes
authors.affiliation: Serviço de Cardiologia do Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Débora
authors.initials: D
authors.lastname: Repolho
authors.affiliation: Serviço de Cardiologia do Hospital Garcia de Orta, Almada, Portugal.
authors.forename: Hélder
authors.initials: H
authors.lastname: Pereira
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011446:Prospective Studies; D014463:Ultrasonography; D055815:Young Adult
keywords: Contractile reserve; Ecocardiografia de esforço; Exercise echocardiography; Hipertensão pulmonar; Pulmonary hypertension; Reserva contrátil; Right ventricle; Ventrículo direito