Determining the Role of Tissue Doppler, Strain and 3D Echocardiographic Parameters in Pulmonary Hypertension

Abstract

Introduction: Several echocardiographic parameters study right ventricular (RV) function, which has a prognostic impact on pulmonary hypertension (PH). Echocardiography is also more affordable for serial testing and more universally available than other cardiac imaging tests such as cardiac magnetic resonance imaging (MRI).

Aims: Our goal was to evaluate the correlation between known prognostic markers and standard, as well as advanced echocardiographic parameters, including Tissue Doppler (TDI), strain imaging and three-dimensional (3D) echocardiography.

Methods: 51 patients (pts) with PH were prospectively studied and the following variables (among others) were analysed: Right Atrial Area/Volume and Global Longitudinal Strain (GLS), Tricuspid Annular Plane Systolic Excursion (TAPSE), RV Fractional Area Change, RV GLS, RV Tei Index, Pulmonary Artery Systolic Pressure (PASP), Pulmonary Acceleration Time (PAcT), Tricuspid s’. In 42 pts, the following 3D variables were calculated: RV end-systolic (ES), end-diastolic (ED) volumes (V) and ejection fraction (EF). Data regarding clinical/demographic characteristics, six-minute walk test (6MWT) and brain natriuretic peptide (BNP) were also collected.

Results: There was a statistically significant (p < 0.05) correlation between 6MWT and RV Tei Index (r = -0.336), PASP (r = -0.388), PAcT (r = 0.661), RVESV (r = -0.380), RVEF (r = 0.381), as well as between BNP and TAPSE (r = -0.332),ytu5 Tricuspid s’ (r = -0.29), PAcT (r = -0.31), RV GLS (r = 0.385), RVESV (r = 0.405), RVEDV (r = 0.445).

Conclusions: Traditional echocardiographic parameters, which have several limitations, as well as advanced parameters, particularly RV GLS and EDV/EF obtained by 3D echocardiography, showed a significant correlation with well-studied prognostic markers in this PH population, reinforcing the need for a more comprehensive study of RV function.