title: Speckle Tracking Echocardiography to Evaluate for Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease.
abstract: Pulmonary hypertension (PH) is a common complication of chronic obstructive pulmonary disease (COPD), increasing morbidity and mortality. Current echocardiographic measures have poor predictive value for the diagnosis of PH in COPD. Right ventricular (RV) strain obtained by speckle tracking echocardiography (STE) is a measure of myocardial deformation which correlates with RV function and survival in subjects with pulmonary arterial hypertension. We hypothesized that RV strain measurements would be feasible and correlate with invasive hemodynamic measurements in patients with COPD. Retrospective analysis of RV strain values from subjects with severe COPD with echocardiogram within 48 hours of right heart catheterization was performed. First, 54 subjects were included in the analysis. Right ventricular systolic pressure (RVSP) and RV strain could be estimated in 31% and 57%, respectively. Then, 61% had RV-focused apical views, and of those, RV strain could be obtained for 94%. RV free wall strain correlated with PVR (r = 0.41, p = 0.02). Subjects with pulmonary vascular resistance (PVR) > 3 Wood units (WU) had less negative (worse) RV free wall strain values than those with PVR ≤ 3 WU, with a median strain of -20 (-23, -12) versus -23 (-29, -15), p < 0.05. A receiver operating characteristic curve demonstrated an RV free wall strain of > -23 to be 92% sensitive and 44% specific for identifying PVR > 3 WU (AUC 0.71). RV strain estimates are feasible in the majority of subjects with severe COPD. RV strain correlates with PVR and may improve screening for PH in subjects with COPD.
authors.affiliation: a Division of Pulmonary Sciences and Critical Care Medicine , University of Colorado , Aurora , Colorado , USA.|b Colorado Pulmonary Vascular Disease Center , University of Colorado , Aurora , Colorado , USA.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Rice
authors.affiliation: a Division of Pulmonary Sciences and Critical Care Medicine , University of Colorado , Aurora , Colorado , USA.|b Colorado Pulmonary Vascular Disease Center , University of Colorado , Aurora , Colorado , USA.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Stream
authors.affiliation: a Division of Pulmonary Sciences and Critical Care Medicine , University of Colorado , Aurora , Colorado , USA.|b Colorado Pulmonary Vascular Disease Center , University of Colorado , Aurora , Colorado , USA.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Fox
authors.affiliation: a Division of Pulmonary Sciences and Critical Care Medicine , University of Colorado , Aurora , Colorado , USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Geraci
authors.affiliation: a Division of Pulmonary Sciences and Critical Care Medicine , University of Colorado , Aurora , Colorado , USA.
authors.forename: R William
authors.initials: RW
authors.lastname: Vandivier
authors.affiliation: b Colorado Pulmonary Vascular Disease Center , University of Colorado , Aurora , Colorado , USA.|c Division of Cardiovascular Medicine , University of Colorado , Aurora , Colorado , USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Dorosz
authors.affiliation: a Division of Pulmonary Sciences and Critical Care Medicine , University of Colorado , Aurora , Colorado , USA.|b Colorado Pulmonary Vascular Disease Center , University of Colorado , Aurora , Colorado , USA.|c Division of Cardiovascular Medicine , University of Colorado , Aurora , Colorado , USA.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Bull
mesh_terms: D001794:Blood Pressure; D006328:Cardiac Catheterization; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology; D012372:ROC Curve; D012189:Retrospective Studies; D013599:Systole; D014655:Vascular Resistance; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: echocardiogram; right ventricle; strain