Open AccessPhenotyping the Right Ventricle in Patients with Pulmonary Hypertension
Author(s) -
Simon Marc A.,
Deible Christopher,
Mathier Michael A.,
Lacomis Joan,
Goitein Orly,
Shroff Sanjeev G.,
Pinsky Michael R.
Publication year - 2009
Publication title -
clinical and translational science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.303
H-Index - 44
eISSN - 1752-8062
pISSN - 1752-8054
DOI - 10.1111/j.1752-8062.2009.00134.x
Subject(s) - cardiology , medicine , pulmonary hypertension , decompensation , ventricle , ejection fraction , pulmonary artery , heart failure with preserved ejection fraction , hemodynamics , diastole , heart failure , blood pressure
Right ventricular (RV) failure is associated with poor outcomes in pulmonary hypertension (PH). We sought to phenotype the RV in PH patients with compensated and decompensated RV function by quantifying regional and global RV structural and functional changes. Twenty‐two patients (age 51 ± 11, 14 females, mean pulmonary artery (PA) pressure range 13–79 mmHg) underwent right heart catheterization, echocardiography, and ECG‐gated multislice computed tomography of the chest. Patients were divided into three groups: Normal, PH with hemodynamically compensated, and decompensated RV function (PH‐C and PH‐D, respectively). RV wall thickness (WT) was measured at end‐diastole (ED) and end‐systole (ES) in three regions: infundibulum, lateral free wall, and inferior free wall. Globally, RV volumes progressively increased from Normal to PH‐C to PH‐D and RV ejection fraction decreased. Regionally, WT increased and fractional wall thickening (FWT) decreased in a spatially heterogeneous manner. Infundibular wall stress was elevated and FWT was lower regardless of the status of global RV function. In PH, there are significant phenotypic abnormalities in the RV even in the absence of overt hemodynamic RV decompensation. Regional changes in RV structure and function may be early markers of patients at risk for developing RV failure.