title: Subclinical Right Ventricular Dysfunction in Patients with Severe Aortic Stenosis: A Retrospective Case Series.
abstract: BACKGROUND
  There is scarce information about right ventricle (RV) function in patients with secondary pulmonary hypertension (PH) undergoing transcatheter aortic valve implantation (TAVI). We aim to identify possible RV abnormalities in patients referred for TAVI with severe aortic stenosis (sAS) and secondary PH.
  
  
  METHODS
  Objective measures of RV function, as well as noninvasive estimates of pulmonary artery systolic pressures (PASP) were obtained from 30 sAS patients undergoing percutaneous valve intervention.
  
  
  RESULTS
  Sixteen (53%) evaluated patients had some degree of PH. As expected, left ventricular mass index (281 ± 75 g/m2) and left atrial volume index (89 ± 23 mL/m2) values were significantly elevated. Even though RV end-systolic (8 ± 4 cm2) and end-diastolic (17 ± 4 cm2) areas were normal as well as RV fractional area change values (57 ± 16%); both longitudinal measures of RV systolic function such as tricuspid annular plane systolic excursion (1.9 ± 0.5 cm) and systolic velocity (10 ± 2 cm/s) were clearly reduced with just mild elevations in PASP (54 ± 7 mmHg).
  
  
  CONCLUSIONS
  Subclinical RV dysfunction is present in patients with sAS and secondary PH undergoing TAVI. Whether longitudinal measures of RV systolic function could predict clinical outcomes in these patients needs to be further explored.
authors.affiliation: Department of Medicine, University of Puerto Rico School of Medicine, San Juan, Puerto Rico.
authors.forename: Dagmar F
authors.initials: DF
authors.lastname: Hernandez-Suarez
authors.affiliation: Cardiovascular Medicine Division, University of Puerto Rico School of Medicine, San Juan, Puerto Rico. angel.lopez17@upr.edu.
authors.forename: Angel
authors.initials: A
authors.lastname: López-Candales
keywords: Echocardiography; Pulmonary hypertension; Severe aortic stenosis; Subclinical right ventricular dysfunction