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We examined the feasibility and reliability of a combined echocardiographic and right heart catheterization (RHC) approach for right ventriculo/arterial (R-V/A) coupling assessment in HF patients with dilated cardiomyopathy (D-CMP).
This is a single center, retrospective cross-sectional study. In 2016-17, for 6 months, we evaluated for eligibility 81 consecutive D-CMP patients afferent to "Niguarda Great Metropolitan Hospital" for RHC and echocardiography. All participants underwent the exams in the context of heart-transplant or advanced HF evaluation. Inclusion criteria were: 18 years old, given informed consent, D-CMP, New York Heart Association (NYHA) functional class II or III and reduced EF (≤ 35%). On the contrary, exclusion criteria were: missing the inclusion criteria and refused informed consent. The final sample consisted of 68 study participants (mean age 64±7 years, 82 % male).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| No Pulonary Hypertension | the presence of mean pulmonary pressures (PAPm) at the right heart catheterization < 25 mmHg |
| |
| Postcapillary Pulmonary Hypertension | PAPm ≥ 25 mmHg and postcapillary wedge pressure (PCWP) >15 mmHg |
| |
| combined postcapillary/precapillary Pulmonary Hypertension | PAPm ≥ 25 mmHg, PAWP >15 mmHg and diastolic peak gradient (DPG - diastolic pulmonary pressure - PCWP) ≥7 mmHg and/or pulmonary vascular resistence (PVR) >3 WU, where available. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Ventriculo-arterial coupling assessment (R-V/A) | Diagnostic Test | R-V/A was achieved by computing the R-Elv/P-Ea ratio (Right ventricular elastance/Pulmonary arterial elastance). R-Elv was computed as PAPm / end-systolic area (ESA) of the right ventricle. P-Ea was obtained as (PAPm-PCWP)/ right ventricle stroke volume (R-SV). |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants with altered Right ventriculo/arterial (R-V/A) coupling over PAPm and Pulmonary Hypertension types | Significant correlations and augmentation over PAPm and Pulmonay Hypertension | up to 24 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of agreement in Right ventriculo/arterial (R-V/A) coupling assessment | Two independent physicians, both experts in echocardiography, independently re-examined 40 studies, randomly selected from all the acquired echocardiographic images. In order to test the R-V/A coupling interobserver agreement | up to 24 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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Participants underwent the exams in the context of heart-transplant or advanced HF evaluation.
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| Name | Affiliation | Role |
|---|---|---|
| Francesco Bianco, MD | Institute of Cardiology - University "G. d'Annunzio" - Chieti, Italy | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University "G. d'Annunzio" | Chieti | 66100 | Italy | |||
| Niguarda Great Metropolitan Hospital |
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| ID | Term |
|---|---|
| D002311 | Cardiomyopathy, Dilated |
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D006332 | Cardiomegaly |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D009202 | Cardiomyopathies |
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|
| Milan |
| Italy |
| D000083083 |
| Laminopathies |
| D030342 | Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |