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Right heart size and function significantly correlate in patients with pulmonary arterial hypertension – a cross-sectional study

Fischer, Lukas ; Benjamin, Nicola ; Blank, Norbert ; Egenlauf, Benjamin ; Fischer, Christine ; Harutyunova, Satenik ; Koegler, Maria ; Lorenz, Hanns-Martin ; Marra, Alberto M. ; Nagel, Christian ; Xanthouli, Panagiota ; Bossone, Eduardo ; Grünig, Ekkehard

In: Respiratory Research, 19 (2018), Nr. 216. pp. 1-13. ISSN 1465-993X

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Download (1MB) | Lizenz: Creative Commons LizenzvertragRight heart size and function significantly correlate in patients with pulmonary arterial hypertension – a cross-sectional study by Fischer, Lukas ; Benjamin, Nicola ; Blank, Norbert ; Egenlauf, Benjamin ; Fischer, Christine ; Harutyunova, Satenik ; Koegler, Maria ; Lorenz, Hanns-Martin ; Marra, Alberto M. ; Nagel, Christian ; Xanthouli, Panagiota ; Bossone, Eduardo ; Grünig, Ekkehard underlies the terms of Creative Commons Attribution 4.0

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Abstract

Background: The objective of this study was to assess, whether right atrial (RA) and ventricular (RV) size is related to RV pump function at rest and during exercise in patients with pulmonary arterial hypertension (PAH).

Methods: We included 54 patients with invasively diagnosed PAH that had been stable on targeted medication. All patients underwent clinical assessments including right heart catheterization and echocardiography at rest and during exercise. RV output reserve was defined as increase of cardiac index (CI) from rest to peak exercise (∆CIexercise). Patients were classified according to the median of RA and RV-area. RV pump function and further clinical parameters were compared between groups by student’s t-test. Uni- and multivariate Pearson correlation analyses were performed.

Results: Patients with larger RA and/or RV-areas (above a median of 16 and 20cm2, respectively) showed significantly lower ∆CIexercise, higher mean pulmonary arterial pressure, pulmonary vascular resistance at rest and NT-proBNP levels. Furthermore, patients with higher RV-areas presented with a significantly lower RV stroke volume and pulmonary arterial compliance at peak exercise than patients with smaller RV-size. RV area was identified as the only independent predictor of RV output reserve.

Conclusion: RV and RA areas represent valuable and easily accessible indicators of RV pump function at rest and during exercise. Cardiac output reserve should be considered as an important clinical parameter. Prospective studies are needed for further evaluation.

Item Type: Article
Journal or Publication Title: Respiratory Research
Volume: 19
Number: 216
Publisher: BioMed Central
Place of Publication: London
Date Deposited: 03 Jan 2019 16:12
Date: 2018
ISSN: 1465-993X
Page Range: pp. 1-13
Faculties / Institutes: Medizinische Fakultät Heidelberg > Medizinische Universitäts-Klinik und Poliklinik
Medizinische Fakultät Heidelberg > Institut für Humangenetik
Medizinische Fakultät Heidelberg > Thoraxklinik Heidelberg gGmbH
Subjects: 610 Medical sciences Medicine
Uncontrolled Keywords: Pulmonary hypertension, Right ventricular output reserve, Pump function, Right ventricular size, Right atrial size
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