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The International Journal of Cardiovascular Imaging

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01-08-2019 | Echocardiography | Original Paper

Two-dimensional speckle tracking echocardiography assessed right ventricular function and exercise capacity in pre-capillary pulmonary hypertension

Authors: Bing-Yang Liu, Wei-Chun Wu, Qi-Xian Zeng, Zhi-Hong Liu, Li-Li Niu, Yue Tian, Xiao-Ling Cheng, Qin Luo, Zhi-Hui Zhao, Li Huang, Hao Wang, Jian-Guo He, Chang-Ming Xiong

Published in: The International Journal of Cardiovascular Imaging | Issue 8/2019

Abstract

Resting two-dimensional speckle tracking echocardiography (2D-STE) identified right ventricular (RV) systolic function were reported to predict exercise capacity in pulmonary hypertension (PH) patients, but little attention had been payed to 2D-STE detected RV diastolic function. Therefore, we aim to elucidate and compare the relations between 2D-STE identified RV diastolic/systolic functions and peak oxygen consumption (PVO₂) determined by cardiopulmonary exercise testing (CPET) in pre-capillary PH. 2D-STE was performed in 66 pre-capillary PH patients and 28 healthy controls. Linear correlation and multivariate regression analyses were performed to evaluate and compare the relations between RV 2D-STE parameters and PVO₂. Receiver operating characteristic curves were used to compare the predictive value of 2D-STE parameters in predicting the cut-off—PVO₂ < 11 ml/min/kg. There were significant differences of all the 2D-STE parameters between PH patients and healthy controls. In patients, RV-peak global longitudinal strain (GLS, r_s = − 0.498, P < 0.001), RV- peak systolic strain rate (GSRs, r_s = − 0.537, P < 0.001) and RV- peak early diastolic strain rate (GSRe, r_s = 0.527, P < 0.001) significantly correlated with PVO₂, but no significant correlation was observed between RV- peak late diastolic strain rate (GSRa, r_s = 0.208, P = 0.093) and PVO₂. The first multivariate regression analysis of clinical data without echocardiographic parameters identified WHO functional class, NT-proBNP and BMI as independent predictors of PVO₂ (Model-1, adjusted r² = 0.421, P < 0.001); Then we added conventional echocardiographic parameters and 2D-STE parameters to the clinical data, identified S,(Model-2,adjusted r² = 0.502, P < 0.001), RV-GLS (Model-3, adjusted r² = 0.491, P < 0.001), RV-GSRe (Model-4, adjusted r² = 0.500, P < 0.001) and RV-GSRs (Model-5, adjusted r² = 0.519, P < 0.001) as independent predictors of PVO₂, respectively. The predictive power was increased, and Model-5 including RV-GSRs showed the highest predictive capability. ROC curves found RV-GSRs expressed the strongest predictive value (AUC = 0.88, P < 0.001), and RV-GSRs > − 0.65/s had a 88.2% sensibility and 82.2% specificity to predict PVO₂ < 11 ml/min/kg. 2D-STE assessed RV function improves the prediction of exercise capacity represented by PVO₂ in pre-capillary PH.

Graphical abstract

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Title: Two-dimensional speckle tracking echocardiography assessed right ventricular function and exercise capacity in pre-capillary pulmonary hypertension
Authors: Bing-Yang Liu
Wei-Chun Wu
Qi-Xian Zeng
Zhi-Hong Liu
Li-Li Niu
Yue Tian
Xiao-Ling Cheng
Qin Luo
Zhi-Hui Zhao
Li Huang
Hao Wang
Jian-Guo He
Chang-Ming Xiong
Publication date: 01-08-2019
Publisher: Springer Netherlands
Keywords: Echocardiography
Pulmonary Hypertension
Echocardiography
Pulmonary Hypertension
Pulmonary Hypertension
Pulmonary Hypertension
Published in: The International Journal of Cardiovascular Imaging / Issue 8/2019
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-019-01605-w

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