Skip to main content
Log in

Comparison of echocardiographic parameters to assess right ventricular function in pulmonary hypertension

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Although measurement of right ventricular ejection fraction (RVEF) may be relevant for evaluation of therapeutic efficacy and/or prognosis in patients with pulmonary hypertension, RVEF obtained by echocardiography has limited accuracy. In contrast, radionuclide and/or magnetic resonance imaging can measure RVEF more reliably. In this study, we investigated the relationship between RVEF measured by radionuclide angiography and the echocardiographic parameters that are recommended by the American Society of Echocardiography as representative of right heart function. There were 23 study participants with pulmonary hypertension who underwent radionuclide angiography and 2-dimensional and Doppler echocardiography (n = 30 measurements). RVEF measured by radionuclide angiography correlated with right ventricular Tei index (RV Tei index) measured by Doppler echocardiography (r = −0.601, P < 0.0005). Receiver operating characteristic curve analysis showed that an RV Tei index cut-off value of 0.371 was the best of predictor of RVEF ≤35% (area under the curve = 0.768, sensitivity = 0.857, selectivity = 0.667). Multiple regression analysis showed that RVEF was correlated with the RV Tei index, and this association was independent of other echocardiographic right ventricular function parameters (r = −0.644, P < 0.005). The RV Tei index measured by Doppler echocardiography may be an acceptable surrogate marker of RVEF in patients with pulmonary hypertension.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Brent BN, Mahler D, Matthay RA, Berger HJ, Zaret BL, Lister G (1984) Noninvasive diagnosis of pulmonary arterial hypertension in chronic obstructive pulmonary disease: right ventricular ejection fraction at rest. Am J Cardiol 53(9):1349–1353

    Article  CAS  PubMed  Google Scholar 

  2. Kawut SM, Al-Naamani N, Agerstrand C, Rosenzweig EB, Rowan C, Barst RJ, Bergmann S, Horn EM (2009) Determinants of right ventricular ejection fraction in pulmonary arterial hypertension. Chest 135(3):752–759

    Article  PubMed  Google Scholar 

  3. Zafrir N, Zingerman B, Solodky A, Ben-Dayan D, Sagie A, Sulkes J, Mats I, Kramer MR (2007) Use of noninvasive tools in primary pulmonary hypertension to assess the correlation of right ventricular function with functional capacity and to predict outcome. Int J Cardiovasc Imaging 23(2):209–215

    Article  PubMed  Google Scholar 

  4. van de Veerdonk MC, Kind T, Marcus JT, Mauritz GJ, Heymans MW, Bogaard HJ, Boonstra A, Marques KM, Westerhof N, Vonk-Noordegraaf A (2011) Progressive right ventricular dysfunction in patients with pulmonary arterial hypertension responding to therapy. J Am Coll Cardiol 58(24):2511–2519

    Article  PubMed  Google Scholar 

  5. Briongos Figuero S, Moya Mur JL, García-Lledó A, Centella T, Salido L, Aceña Navarro Á, García Martín A, García-Andrade I, Oliva E, Zamorano JL (2016) Predictors of persistent pulmonary hypertension after mitral valve replacement. Heart Vessels 31(7):1091–1099

    Article  PubMed  Google Scholar 

  6. Hioka T, Kaga S, Mikami T, Okada K, Murayama M, Masauzi N, Nakabachi M, Nishino H, Yokoyama S, Nishida M, Iwano H, Sakakibara M, Yamada S, Tsutsui H (2016) Overestimation by echocardiography of the peak systolic pressure gradient between the right ventricle and right atrium due to tricuspid regurgitation and the usefulness of the early diastolic transpulmonary valve pressure gradient for estimating pulmonary artery pressure. Heart Vessels. doi:10.1007/s00380-016-0929-4

    PubMed  Google Scholar 

  7. Tei C (1995) New non-invasive index for combined systolic and diastolic ventricular function. J Cardiol 26(2):135–136

    CAS  PubMed  Google Scholar 

  8. Tei C, Ling LH, Hodge DO, Bailey KR, Oh JK, Rodeheffer RJ, Tajik AJ, Seward JB (1995) New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function—a study in normals and dilated cardiomyopathy. J Cardiol 26(6):357–366

    CAS  PubMed  Google Scholar 

  9. Tei C, Dujardin KS, Hodge DO, Bailey KR, McGoon MD, Tajik AJ, Seward SB (1996) Doppler echocardiographic index for assessment of global right ventricular function. J Am Soc Echocardiogr 9(6):838–847

    Article  CAS  PubMed  Google Scholar 

  10. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23(7):685–713

    Article  PubMed  Google Scholar 

  11. Haddad F, Hunt SA, Rosenthal DN, Murphy DJ (2008) Right ventricular function in cardiovascular disease, part I: anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation 117(11):1436–1448

    Article  PubMed  Google Scholar 

  12. Rushmer RF, Crystal DK, Wagner C (1953) The functional anatomy of ventricular contraction. Circ Res 1(2):162–170

    Article  CAS  PubMed  Google Scholar 

  13. Petitjean C, Rou N, Cluzel P (2005) Assessment of myocardial function: a review of quantification methods and results using tagged MRI. J Cardiovasc Magn Reson 7(2):501–516

    Article  PubMed  Google Scholar 

  14. Vanderpool RR, Richard F, Naeije R, Hunter K, Simon MA (2016) Simple functional imaging of the right ventricle in pulmonary hypertension: can right ventricular ejection fraction be improved? Int J Cardiol 223:93–94

    Article  PubMed  Google Scholar 

  15. Anavekar NS, Gerson D, Skali H, Kwong RY, Yucel EK, Solomon SD (2007) Two-dimensional assessment of right ventricular function: an echocardiographic-MRI correlative study. Echocardiography 24(5):452–456

    Article  PubMed  Google Scholar 

  16. Kaul S, Tei C, Hopkins JM, Shah PM (1984) Assessment of right ventricular function using two-dimensional echocardiography. Am Heart J 107(3):526–531

    Article  CAS  PubMed  Google Scholar 

  17. Pavlicek M, Wahl A, Rutz T, de Marchi SF, Hille R, Wustmann K, Steck H, Eigenmann C, Schwerzmann M, Seiler C (2011) Right ventricular systolic function assessment: rank of echocardiographic methods vs. cardiac magnetic resonance imaging. Eur J Echocardiogr 12(11):871–880

    Article  PubMed  Google Scholar 

  18. Courand PY, Pina Jomir G, Khouatra C, Scheiber C, Turquier S, Glérant JC, Mastroianni B, Gentil B, Blanchet-Legens AS, Dib A, Derumeaux G, Humbert M, Mornex JF, Cordier JF, Cottin V (2015) Prognostic value of right ventricular ejection fraction in pulmonary arterial hypertension. Eur Respir J 45(1):139–149

    Article  CAS  PubMed  Google Scholar 

  19. Badagliacca R, Papa S, Valli G, Pezzuto B, Poscia R, Manzi G, Giannetta E, Sciomer S, Palange P, Naeije R, Fedele F, Vizza CD (2016) Echocardiography combined with cardiopulmonary exercise testing for the prediction of outcome in idiopathic pulmonary arterial hypertension. Chest 150(6):1313–1322

    Article  PubMed  Google Scholar 

  20. Ghio S, Pica S, Klersy C, Guzzafame E, Scelsi L, Raineri C, Turco A, Schirinzi S, Visconti LO (2016) Prognostic value of TAPSE after therapy optimisation in patients with pulmonary arterial hypertension is independent of the haemodynamic effects of therapy. Open Heart 3(1):e000408

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hsiao SH, Lin SK, Wang WC, Yang SH, Gin PL, Liu CP (2006) Severe tricuspid regurgitation shows significant impact in the relationship among peak systolic tricuspid annular velocity, tricuspid annular plane systolic excursion, and right ventricular ejection fraction. J Am Soc Echocardiogr 19(7):902–910

    Article  PubMed  Google Scholar 

  22. Yeo TC, Dujardin KS, Tei C, Hodge DO, Rossi A, Seward JB (1998) Value of a Doppler-derived index combining systolic and diastolic time intervals in predicting outcome in primary pulmonary hypertension. Am J Cardiol 81(9):1157–1161

    Article  CAS  PubMed  Google Scholar 

  23. Vonk Noordegraaf A, Westerhof BE, Westerhof N (2017) The relationship between the right ventricle and its load in pulmonary hypertension. J Am Coll Cardiol 69(2):236–243

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shichiro Abe.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Amano, H., Abe, S., Hirose, S. et al. Comparison of echocardiographic parameters to assess right ventricular function in pulmonary hypertension. Heart Vessels 32, 1214–1219 (2017). https://doi.org/10.1007/s00380-017-0991-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-017-0991-6

Keywords

Navigation