Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Right atrial mechanics by strain echocardiography in chronic thromboembolic pulmonary hypertension
Session:
Painel 10 - Doença Valvular 10
Speaker:
Marta Sofia Ferreira Fonseca
Congress:
CPC 2020
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
Subtheme:
21.2 Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Marta Ferreira Fonseca; Rui Baptista; Gonçalo Samouco; Paula Soeiro; Rui M. Martins; Graça Castro; Lino Gonçalves
Abstract
<p><strong>Introduction: </strong>Chronic thromboembolic pulmonary hypertension (CPTEH) is the result of thromboemboli that occlude the pulmonary vascular bed, leading not only to mechanical obstruction but also pulmonary vascular remodelling, progressive pulmonary hypertension (PH), an increase in right heart afterload and eventually right heart failure (if left untreated). Prognostic assessment in CPTEH is complex and multifactorial<strong>. </strong></p> <p><strong>Purpose: </strong>We used two-dimensional strain echocardiography (2D-STE) to quantify right atrial (RA) mechanics and its correlation with invasive hemodynamics, load-dependent biomarkers and well-known prognostic markers in patients with CTEPH.</p> <p><strong>Methods: </strong>A total of 44 patients with CTEPH were recruited. 2D-STE was used to measure right atrial reservoir strain (RASr) (Figure 1) which was then compared to conventional ultrasound measurements, right heart catheterisation (RHC) measurements, the percentage of obstruction in ventilation-perfusion pulmonary single-photon emission computed tomography (V/Q SPECT), B-type natriuretic peptide (BNP) values and 6-minute walk test (6MWT) performance. All patients underwent transthoracic echocardiographic evaluation with a maximal time distance of three months to RHC.</p> <p><strong>Results: </strong>The population baseline characteristics, VQ/SPECT, RHC parameters and echocardiographic data are summarized in Table 1. There was a significant positive correlation of RASr with RV longitudinal function determined by tricuspid annular plane systolic excursion (r =0.488, p=0.003), tricuspid annular peak systolic velocity (r =0.490, p=0.002), right ventricular outflow tract velocity time integral (r =0.457, p=0.005), as well as with 6MWT (r =0.491, p=0.004). There was a significant negative correlation of RASr with mean pulmonary artery pressure (r = -0.513, p=0.002), pulmonary vascular resistance (r = -0.439, p=0.011) and right atrial pressure (r = -0.513, p=0.002). RASr was also correlated with Log-transformed BNP values (r = -0.552, p<0,001), and in a multivariate linear regression model, RASr was an independent predictor of Log-transformed BNP values (? = -0.448, 95% CI -0.046 – -0.009; p =0.005). There was no correlation between RASr and the percentage of obstruction in V/Q SPECT (r =0.164, p =0.388).</p> <p><strong>Conclusion: </strong>2D-STE-derived RA mechanics demonstrated to be a useful, non-invasive, surrogate measurement of RHC parameters. It also predicted important clinical/laboratory prognostic measurements, such as BNP and 6MWT performance. The absence of correlation between 2D-STE values and the percentage of vessel obstruction determined by SPECT may suggest that RV maladaptive response to the obstruction, rather than the degree of obstruction, dictates right heart failure in CTEPH.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site