Volumetric and Functional Assessment of Ventricles in Pulmonary Hypertension on 3-Dimensional Echocardiography

Toshiro Inaba; Atsushi Yao; Tomoko Nakao; Masaru Hatano; Hisataka Maki; Teruhiko Imamura; Taro Shiga; Tadashi Yamazaki; Makoto Sonoda; Koichiro Kinugawa; Takahiro Shiota; Junichi Suzuki; Katsu Takenaka; Yasunobu Hirata; Ryozo Nagai

doi:10.1253/circj.CJ-12-0203

Pulmonary Circulation

Volumetric and Functional Assessment of Ventricles in Pulmonary Hypertension on 3-Dimensional Echocardiography

Toshiro Inaba, Atsushi Yao, Tomoko Nakao, Masaru Hatano, Hisataka Maki, Teruhiko Imamura, Taro Shiga, Tadashi Yamazaki, Makoto Sonoda, Koichiro Kinugawa, Takahiro Shiota, Junichi Suzuki, Katsu Takenaka, Yasunobu Hirata, Ryozo Nagai

Author information

Toshiro Inaba
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Atsushi Yao
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Tomoko Nakao
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Masaru Hatano
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Hisataka Maki
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Teruhiko Imamura
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Taro Shiga
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Tadashi Yamazaki
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Makoto Sonoda
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Koichiro Kinugawa
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Takahiro Shiota
Cedars-Sinai Medical Center and David Geffen School of Medicine at UCLA
Junichi Suzuki
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Katsu Takenaka
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Yasunobu Hirata
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo
Ryozo Nagai
Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo

Keywords: 3-D echocardiography, Magnetic resonance imaging, Pulmonary hypertension, Pulmonary vascular resistance, Remodeling index

JOURNAL FREE ACCESS

2013 Volume 77 Issue 1 Pages 198-206

DOI https://doi.org/10.1253/circj.CJ-12-0203

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Abstract

Background: Non-invasive assessment of volume and function on the right ventricle (RV) for pulmonary hypertension (PH) is limited. Methods and Results: Patients with PH (n=23) underwent 3-dimensional (D) echocardiography (3DECHO), with cardiac magnetic resonance imaging to confirm its precision, and right heart catheterization. On linear regression analysis the RV end-systolic volume index (ESVI) was positively correlated with pulmonary vascular resistance (PVR) and mean pulmonary arterial pressure (mPAP; R=0.42 and 0.46, P=0.03 and 0.03, respectively). The RV end-diastolic volume index (EDVI) was positively correlated with mPAP (R=0.41, P<0.05). The left ventricular (LV) EDVI was inversely correlated with PVR (R=−0.48, P=0.02). The RV ejection fraction was inversely correlated with PVR and mean right atrial pressure (mRAP; R=−0.57, and −0.45, P=0.004, and 0.03, respectively). RVEDVI/LVEDVI and RVESVI/LVESVI (the diastolic and systolic remodeling indices, respectively) had a significantly positive linear relationship with PVR (R=0.67 and 0.55, P=0.0005 and 0.006, respectively), and the former had a significantly positive linear relationship with mRAP (R=0.42, P<0.05). During the recovery process in 1 specific case, the remodeling indices maintained a significant linear relationship with the hemodynamic parameters. Conclusions: Novel indices provided by 3DECHO may be utilized as alternative indicators of hemodynamic changes in PH patients. (Circ J 2013; 77: 198–206)

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