Prognostic relevance of the right ventricular myo-mechanical index (RV-MMI) in patients with precapillary pulmonary hypertension

• Verfasst von: Greiner, Sebastian [VerfasserIn]
• Verfasst von: Aurich, Matthias [VerfasserIn]
• Verfasst von: Katus, Hugo [VerfasserIn]
• Verfasst von: Mereles, Derliz [VerfasserIn]
• Titel: Prognostic relevance of the right ventricular myo-mechanical index (RV-MMI) in patients with precapillary pulmonary hypertension
• Verf.angabe: Sebastian Greiner, Ferdinand Goppelt, Matthias Aurich, Hugo A. Katus, Derliz Mereles
• E-Jahr: 2018
• Jahr: September 12, 2018
• Umfang: 9 S.
• Fussnoten: Gesehen am 15.05.2019
• Titel Quelle: Enthalten in: Open Heart
• Ort Quelle: London : BMJ, 2013
• Jahr Quelle: 2018
• Band/Heft Quelle: 5(2018,2), Artikel-Nummer e000903, 9 Seiten
• ISSN Quelle: 2044-6055
• ISSN Quelle: 2053-3624
• DOI: doi:10.1136/openhrt-2018-000903
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: pulmonary hypertension
• Sach-SW: right ventricular function
• Sach-SW: strain imaging
• Sach-SW: survival
• Sach-SW: transthoracic (Doppler) echocardiography
• K10plus-PPN: 1665676302

Abstract

Objective The aim of the prospective New-RV study was to evaluate a parameter for non-invasive quantification of right ventricular (RV) dysfunction in patients with precapillary pulmonary hypertension (PH) that yields prognostic information and is applicable in daily clinical routine. - Methods Sixty-five consecutive patients with precapillary PH under guideline conform therapy (43 women, 22 men) underwent clinical assessment, serological testing, as well as a comprehensive transthoracic echocardiography including strain imaging and a detailed assessment of RV haemodynamics. - Results The mean follow-up time was 844 days. Sixteen patients died during clinical follow-up. Right ventricular myo-mechanical index (RV-MMI) was calculated by right atrial size, mean RV pressure gradient and strain imaging of the RV free wall, and was measurable in all examinations. RV-MMI was tested for its diagnostic accuracy (sensitivity of 88% and specificity of 73% for an optimal cut-off value of ≤0.31 mm Hg*%; area under the curve=0.85), as well as its predictive value (HR=3.3, 95% CI 1.6 to 7.0, p<0.001), and was compared in detail with established parameters. RV-MMI and N-terminal pro-brain natriuretic peptide (NTproBNP)were independent predictors of survival (HR=2.9, 95% CI 1.4 to 6.2, p=0.006; and HR=2.6, 95% CI 1.5 to 4.6, p=0.001, respectively). - Conclusion In a cohort of patients with precapillary PH, the RV-MMI differentiates the outcome of patients better than other available non-invasive parameters of RV function by preload and afterload adjusted quantification. - Trial registration number NCT01230294.