par Tello, Khodr;Dalmer, Antonia;Vanderpool, Rebecca ;Ghofrani, Hossein Ardeschir;Naeije, Robert ;Roller, Fritz;Seeger, Werner;Wiegand, Merle;Gall, H.;Richter, Manuel Jonas
Référence American journal of physiology. Heart and circulatory physiology, 317, 6
Publication Publié, 2019
Article révisé par les pairs
Résumé : The functional relevance of right atrial (RA) function in pulmonary hypertension (PH) remains incompletely understood. The purpose of this study was to explore the correlation of cardiac magnetic resonance (CMR) feature tracking-derived RA phasic function with invasively measured pressure-volume (PV) loop-derived right ventricular (RV) end-diastolic elastance (Eed) and RV-arterial coupling [end-systolic/arterial elastance (Ea/Ees)]. In 54 patients with severe PH, CMR was performed within 24 hours of diagnostic right heart catheterization and PV measurements. RA phasic function was assessed by CMR imaging of RA reservoir, passive, and active strain. The association of RA phasic function with indices of RV function was evaluated by Spearman's rank correlation and linear regression analyses. Median [interquartile range] RA reservoir, passive, and active strain were 19.5% [11.0-24.5], 7.0% [4.0-12.0], and 13.0% [7.0-18.5], respectively. Ees/Ea was 0.73 [0.48-1.08] and Eed was 0.14 mm Hg/ml [0.05-0.22]. RV diastolic impairment [RV end-diastolic pressure (EDP) and Eed] was correlated with RA phasic function, but Ea and Ees were not. In addition, RA phasic function was correlated with inferior vena cava diameter. In multivariate linear regression analysis, adjusting for key PV-loop indices, Eed and EDP remained significantly associated with RA phasic function. We conclude that RA phasic function is altered in relation to impaired diastolic function of the chronically overloaded right ventricle, and contributes to backwards venous flow and systemic congestion. These results call for more attention to RA function in the management of patients with PH.

Documents en relation

DI-fusion