Document Detail


Apical systolic eccentricity index: a better marker of right ventricular compromise in pulmonary hypertension.
MedLine Citation:
PMID:  20345450     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Systolic eccentricity index (sEI) has been traditionally measured at the papillary muscle (PM) level. However, this measurement does not take into account the remodeling that occurs in the right ventricle (RV) during chronic pulmonary hypertension (cPH). METHODS: Standard echocardiographic data were collected on 50 patients (age 58 + or - 14 years) with known cPH (74 + or - 22 mmHg; range 45-120 mmHg) who had adequate short-axis views at the mitral valve (MV), PM, and apical (AP) levels to measure sEI. All had a normal left ventricular ejection fraction (72 + or - 10%). RESULTS: In a multivariate analysis, the traditional PM level sEI correlated the best with cPH when pulmonary artery systolic pressures (PASP) ranged between 45 and 60 mmHg (r =-0.569, P < 0.001) while AP level sEI was better when all patients were included in the analysis (r =-0.843, P < 0.0001). Not only was AP level sEI the only echo variable helpful in identifying a dilated end diastolic RV area (r =-0.730, P < 0.0001) but also patients with worse RV systolic performance (r = 0.686, P < 0.0001). MV level sEI was not better than PM level sEI. CONCLUSIONS: AP level sEI appears to be superior to traditional PM level sEI measurement as it correlates better with worsening PH severity, RV cavity dilation and RV systolic dysfunction. Further studies are now required to prospectively study how these septal abnormalities in cPH may affect RV as well as LV systolic and diastolic function. (Echocardiography 2010;27:534-538).
Authors:
Angel López-Candales; Raveen Bazaz; Kathy Edelman; Beth Gulyasy
Publication Detail:
Type:  Journal Article     Date:  2010-03-24
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  27     ISSN:  1540-8175     ISO Abbreviation:  Echocardiography     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-07-08     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  534-8     Citation Subset:  IM    
Affiliation:
Cardiovascular Institute, University of Pittsburgh, Scaife 560, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA. lopezcandalesa@upmc.edu
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Blood Pressure / physiology
Chronic Disease
Echocardiography / methods*
Female
Humans
Hypertension, Pulmonary / etiology,  physiopathology*,  ultrasonography*
Linear Models
Male
Middle Aged
Systole
Ventricular Dysfunction, Left / physiopathology*,  ultrasonography*
Ventricular Function, Right
Ventricular Remodeling / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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