Abstract
Little is known regarding a correlation of hemodynamics at rest or exercise capacity with echocardiographic parameters in patients with pulmonary hypertension (PH). To clarify these potential correlations, we performed transthoracic echocardiography, right heart catheterization, and cardiopulmonary exercise testing in 53 patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Left ventricular end-diastolic dimension (LVDd), early diastolic velocity of the septal mitral annulus (septal e′), tricuspid regurgitation peak gradient (TRPG), and tricuspid annular plane systolic excursion (TAPSE) were significantly correlated with cardiac index (LVDd; r = 0.477, P < 0.001, septal e′; r = 0.463, P = 0.001, TRPG; r = − 0.455, P = 0.001 and TAPSE; r = 0.406, P = 0.003, respectively). Multiple regression analysis revealed that LVDd and septal e′ were significantly associated with cardiac index (CI) and stroke volume index at rest. Among the exercise capacity markers evaluated, TAPSE, TRPG, and LVDd were significantly correlated with peak oxygen uptake (TAPSE; r = 0.534, P < 0.001, TRPG; r = − 0.466, P = 0.001 and LVDd; r = 0.411, P = 0.002, respectively). Multiple regression analysis showed that TAPSE was significantly associated with peak oxygen uptake (VO2). In PAH and CTEPH patients, LVDd and septal e′ were significantly associated with CI at rest, whereas TAPSE was significantly associated with peak VO2. Echocardiographic parameters may predict the prognostic factors of PAH and CTEPH patients.
Highlights
IntroductionSeveral specific therapies have been introduced for the treatment of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH), and patient conditions have been assessed repeatedly in detail
I/HPAH idiopathic/heritable pulmonary arterial hypertension; POPH portopulmonary hypertension; CTD-PAH connective tissue diseaseassociated pulmonary arterial hypertension; CTEPH chronic thromboembolic pulmonary hypertension; WHO World Health Organization; 6MWD six-minute walk distance; ERA endothelin receptor antagonist; PDE-5 phosphodiesterase-5 inhibitor; BNP brain natriuretic peptide variables including clinical and laboratory findings, hemodynamic and echocardiographic parameters, the independent variables used in this analysis, were selected on the basis of a significance of univariate analysis: age, brain natriuretic peptide (BNP), mean pulmonary artery pressure (PAP), E, septal e′, Left ventricular end-diastolic dimension (LVDd), tricuspid annular plane systolic excursion (TAPSE), and tricuspid regurgitation peak gradient (TRPG)
Among the variables including clinical and laboratory findings, hemodynamic and echocardiographic parameters, the independent variables used in this analysis were World Health Organization functional class (WHO-FC), BNP, heart rate, Cardiac index (CI), mean PAP, SvO2, LVDd, TAPSE, and TRPG
Summary
Several specific therapies have been introduced for the treatment of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH), and patient conditions have been assessed repeatedly in detail. Cardiac index (CI), which is obtained during right heart catheterization, and peak oxygen uptake (VO2), which is assessed through cardiopulmonary exercise testing (CPET),. Heart and Vessels (2018) 33:521–528 are established prognostic factors of PAH [23]. Details of the correlation between these invasively acquired prognostic factors and noninvasive echocardiographic parameters are still not enough in patients with PAH and CTEPH. We investigated the potential relationship among hemodynamics at rest, exercise capacity, and the echocardiographic parameters routinely measured at rest in patients with PAH and CTEPH
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
