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1.
Int J Cardiol ; 228: 1035-1040, 2017 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-27931011

RESUMO

BACKGROUND: Pulmonary artery aneurysm (PAA) occurs in some patients with pulmonary arterial hypertension (PAH). We evaluated the characteristics of cardiac dysfunction in patients with PAH complicated by PAA. METHODS: Echocardiography and right-heart catheterization were performed in 130 PAH patients to measure the maximum dimensions of the main pulmonary artery (MPA) trunk and evaluate right ventricular (RV) and left ventricular (LV) function. RESULTS: A diameter of >40mm was defined as PAA in the MPA trunk. The maximum MPA diameter was >40mm in 32 of 130 PAH patients (24.6%: Group PAA). Systolic pulmonary artery pressure (68.0±18.5 vs. 58.9±21.6mm Hg, P=0.0354) and pulmonary capillary wedge pressure (10.8±3.9 vs. 7.7±2.6mm Hg, P<0.0001) were significantly higher in Group PAA than in Group non-PAA. RV end-diastolic area index (19.6±6.8 vs. 14.9±5.1 cm²/m², P<0.0001), and RV fractional area change (32.3±7.8 vs. 37.3±8.8%, P=0.0048) and RV longitudinal strain (-15.4±5.1 vs. -20.4±6.1, P=0.0012) were significantly lower, and E/e' was significantly higher (8.1±2.2 vs. 6.7±1.4, P=0.0002) in Group PAA than in Group non-PAA. CONCLUSIONS: In PAH patients with PAA, RV was larger and RV dysfunction was more severe, and LV diastolic dysfunction appeared. It is important to investigate the appearance of PAA and the severity of RV and LV dysfunction in PAH patients with PAA.


Assuntos
Aneurisma/diagnóstico por imagem , Ecocardiografia Tridimensional , Hipertensão Pulmonar/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Imagem Multimodal/métodos , Artéria Pulmonar/patologia , Adulto , Fatores Etários , Aneurisma/epidemiologia , Aneurisma/fisiopatologia , Cateterismo Cardíaco/métodos , Distribuição de Qui-Quadrado , Estudos de Coortes , Ecocardiografia/métodos , Ecocardiografia Doppler de Pulso/métodos , Feminino , Humanos , Hipertensão Pulmonar/epidemiologia , Hipertensão Pulmonar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores Sexuais , Análise de Sobrevida , Disfunção Ventricular Direita/diagnóstico por imagem , Disfunção Ventricular Direita/epidemiologia , Disfunção Ventricular Direita/fisiopatologia
2.
J Echocardiogr ; 14(1): 30-8, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26613742

RESUMO

BACKGROUND: In patients with pulmonary artery hypertension (PAH), right ventricular pressure overload eventually causes right heart failure (RHF), leading to a poor prognosis. Right atrial (RA) overload and RA dysfunction occur in patients with PAH-complicated RHF. OBJECTIVES: We evaluated RA function using right atrial longitudinal strain (RALS) by two-dimensional speckle tracking echocardiography (2D-STE) and investigated the association between RALS and the severity of RHF in patients with pulmonary artery hypertension (PAH) noninvasively. METHODS: We performed 2D-STE in 56 PAH patients and 20 normal control subjects. The peak global RALS and peak global RA longitudinal strain rate (RALSR) were analyzed by 2D-STE. Simultaneous right heart catheterization was performed to determine the right atrial pressure (RAP) and cardiac index (CI). RESULTS: Peak global RALS (34.6 ± 14.1 vs. 58.3 ± 9.9%, p < 0.0001) and peak global RALSR (2.5 ± 1.3 vs. 3.1 ± 1.2 s(-1), p < 0.0001) were significantly lower in PAH patients compared with normal controls. There was a significant negative correlation between peak global RALS and RAP (r = -0.8037, p < 0.0001). There was a significant positive correlation between peak global RALS and CI (r = 0.8179, p < 0.0001). Peak global RALSR was also correlated with RAP (r = -0.7308, p < 0.0001) and CI (r = 0.7596, p < 0.0001). CONCLUSIONS: RALS and RALSR by 2D-STE were useful for noninvasive evaluation of RA dysfunction and the severity of RHF in patients with PAH.


Assuntos
Função do Átrio Direito , Hipertensão Pulmonar/complicações , Função Atrial , Pressão Atrial , Cateterismo Cardíaco/efeitos adversos , Estudos de Casos e Controles , Átrios do Coração , Humanos , Artéria Pulmonar , Disfunção Ventricular Direita , Função Ventricular Direita
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