title: Two-dimensional echocardiography in the assessment of long-term prognosis in patients with pulmonary arterial hypertension.
abstract: OBJECTIVE
  To investigate the relationship between cardiac diastolic dysfunction and outcomes in patients with pulmonary arterial hypertension (PAH) and to clarify the potential effect of two-dimensional echocardiography (2D-echo) on prognostic value in patients with PAH.
  
  
  METHODS
  Patients diagnosed with PAH (as WSPH (World Symposia on Pulmonary Hypertension) classification I) confirmed by right heart catheterization (RHC), received targeted monotherapy or combination therapy. 2D-echo parameters, World Health Organization (WHO) functional classification and 6-minute walking distance (6MWD) were recorded. The clinical prognosis of patients was assessed by the correlation between echo parameters and clinical 6MWD using receiver operating characteristic (ROC) curve analysis.
  
  
  RESULTS
  Fifty-eight patients were included. Left and right ventricular diastolic dysfunction (LVDD and RVDD) scores measured by 2D-echo had good correlation with 6MWD at baseline (rLVDD  = -0.699; rRVDD  = -0.818, both P < 0.001) and at last follow-up (rLVDD  = -0.701; rRVDD  = -0.666, both P<0.001). Furthermore, bi-ventricular (LVDD + RVDD) scores measured by 2D-echo had a better correlation with 6MWD at baseline and last follow-up (r =  0.831; r = -0.771, both P < 0.001). ROC curve analysis showed that the area under curves (AUCs) for LVDD score, RVDD score and (LVDD + RVDD) scores were 0.823 (P < 0.0001), 0.737 (P = 0.0002), and 0.825 (P < 0.0001), respectively. Compared with ROC analysis of other single parameters, cardiac diastolic function score was more accurate in predicting survival in patients with PAH.
  
  
  CONCLUSIONS
  LVDD score, RVDD score and (LVDD + RVDD) scores yielded a comprehensive quantitative assessment of LV and RV diastolic function that correlated moderately with clinical functional parameters and might be useful in the assessment of PAH.
authors.affiliation: Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Ling-yue
authors.initials: LY
authors.lastname: Sun
authors.affiliation: Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Xue-dong
authors.initials: XD
authors.lastname: Shen
authors.affiliation: Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Zong-ye
authors.initials: ZY
authors.lastname: Cai
authors.affiliation: Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Jie-yan
authors.initials: JY
authors.lastname: Shen
authors.affiliation: Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Ben
authors.initials: B
authors.lastname: He
authors.affiliation: Department of Rheumatology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Cheng-de
authors.initials: CD
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D003971:Diastole; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000473:pathology*; D012372:ROC Curve; D018497:Ventricular Dysfunction, Right / Q000503:physiopathology*; D055815:Young Adult