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Erschienen in: Wiener klinische Wochenschrift 21-22/2015

01.11.2015 | original article

Right ventricular and atrial functions in patients with nonischemic dilated cardiomyopathy

verfasst von: MD Assoc. Prof. Kursat Tigen, MD Assoc. Prof. Tansu Karaahmet, MD Cihan Dundar, MD Altug Cincin, MD Assoc. Prof. Beste Ozben, MD Ahmet Guler, MD Emre Gurel, MD Murat Sunbul, MD Prof. Yelda Basaran

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 21-22/2015

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Summary

Objective

The aim of this study was to assess the right ventricular and right atrial functions in patients with nonischemic dilated cardiomyopathy by novel echocardiographic measures.

Methods

In all, 40 patients with nonischemic dilated cardiomyopathy and 26 healthy subjects were consecutively included. Left ventricular, right ventricular, and right atrial functions were assessed by tissue Doppler imaging and two-dimensional speckle tracking echocardiography. Right ventricular systolic dysfunction was accepted moderated to severe when tissue Doppler peak systolic velocity of tricuspid lateral annulus was < 9 cm/s.

Results

In all, 18 of the 40 nonischemic dilated cardiomyopathy patients had peak systolic velocity of tricuspid lateral annulus < 9 cm/s and had significantly lower right ventricular free wall basal segment longitudinal strain, displacement, and right atrial functions assessed by speckle tracking echocardiography. Left ventricular tissue Doppler systolic velocity, global longitudinal and circumferential strain values were also lower in patients with moderated to severe right ventricular systolic dysfunction. Receiver operating characteristic analysis was preformed to assess the utility of right ventricular free wall basal segment longitudinal strain to predict right ventricular systolic dysfunction (peak systolic velocity < 9 cm/s). The cut off value for predicting right ventricular systolic dysfunction was − 20 % with a sensitivity of 72%  and specificity of 73%  (AUC: 0.793; p = 0.002; 95 % confidence interval: 0.645–0.941).

Conclusions

Right ventricular systolic function is impaired in nonischemic dilated cardiomyopathy patients. Two-dimensional speckle tracking echocardiography represents a promising noninvasive method to evaluate right ventricular and atrial function in this patient group.
Literatur
1.
Zurück zum Zitat D’Andrea A, Salerno G, Scarafile R, et al. Right ventricular myocardial function in patients with either idiopathic or ischemic dilated cardiomyopathy without clinical sign of right heart failure: effects of cardiac resynchronization therapy. Pacing Clin Electrophysiol. 2009;32(8):1017–29. CrossRefPubMed D’Andrea A, Salerno G, Scarafile R, et al. Right ventricular myocardial function in patients with either idiopathic or ischemic dilated cardiomyopathy without clinical sign of right heart failure: effects of cardiac resynchronization therapy. Pacing Clin Electrophysiol. 2009;32(8):1017–29. CrossRefPubMed
2.
Zurück zum Zitat Meluzin J, Spinarova L, Dusek L, Toman J, Hude P, Krejci J. Prognostic importance of the right ventricular function assessed by Doppler tissue imaging. Eur J Echocardiogr. 2003;4(4):262–71. CrossRefPubMed Meluzin J, Spinarova L, Dusek L, Toman J, Hude P, Krejci J. Prognostic importance of the right ventricular function assessed by Doppler tissue imaging. Eur J Echocardiogr. 2003;4(4):262–71. CrossRefPubMed
3.
Zurück zum Zitat Chin KM, Kim NH, Rubin LJ. The right ventricle in pulmonary hypertension. Coron Artery Dis. 2005;16(1):13–8. CrossRefPubMed Chin KM, Kim NH, Rubin LJ. The right ventricle in pulmonary hypertension. Coron Artery Dis. 2005;16(1):13–8. CrossRefPubMed
4.
Zurück zum Zitat Kukulski T, Hubbert L, Arnold M, Wranne B, Hatle L, Sutherland GR. Normal regional right ventricular function and its change with age: a Doppler myocardial imaging study. J Am Soc Echocardiogr. 2000;13(3):194–204. CrossRefPubMed Kukulski T, Hubbert L, Arnold M, Wranne B, Hatle L, Sutherland GR. Normal regional right ventricular function and its change with age: a Doppler myocardial imaging study. J Am Soc Echocardiogr. 2000;13(3):194–204. CrossRefPubMed
5.
Zurück zum Zitat Vogel M, Schmidt MR, Kristiansen SB, et al. Validation of myocardial acceleration during isovolumic contraction as a novel noninvasive index of right ventricular contractility: comparison with ventricular pressure-volume relations in an animal model. Circulation. 2002;105(14):1693–9. CrossRefPubMed Vogel M, Schmidt MR, Kristiansen SB, et al. Validation of myocardial acceleration during isovolumic contraction as a novel noninvasive index of right ventricular contractility: comparison with ventricular pressure-volume relations in an animal model. Circulation. 2002;105(14):1693–9. CrossRefPubMed
6.
Zurück zum Zitat Padeletti M, Cameli M, Lisi M, Malandrino A, Zaca V, Mondillo S. Reference values of right atrial longitudinal strain imaging by two-dimensional speckle tracking. Echocardiography. 2012;29(2):147–52. CrossRefPubMed Padeletti M, Cameli M, Lisi M, Malandrino A, Zaca V, Mondillo S. Reference values of right atrial longitudinal strain imaging by two-dimensional speckle tracking. Echocardiography. 2012;29(2):147–52. CrossRefPubMed
7.
Zurück zum Zitat Ahmad H, Mor-Avi V, Lang RM, et al. Assessment of right ventricular function using echocardiographic speckle tracking of the tricuspid annular motion: comparison with cardiac magnetic resonance. Echocardiography. 2012;29(1):19–24. CrossRefPubMed Ahmad H, Mor-Avi V, Lang RM, et al. Assessment of right ventricular function using echocardiographic speckle tracking of the tricuspid annular motion: comparison with cardiac magnetic resonance. Echocardiography. 2012;29(1):19–24. CrossRefPubMed
8.
Zurück zum Zitat Salerno G, D’Andrea A, Bossone E, et al. Association between right ventricular two-dimensional strain and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy. J Cardiovasc Med (Hagerstown). 2011;12(9):625–34. Salerno G, D’Andrea A, Bossone E, et al. Association between right ventricular two-dimensional strain and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy. J Cardiovasc Med (Hagerstown). 2011;12(9):625–34.
9.
Zurück zum Zitat Gunnarsson G, Eriksson P, Dellborg M. ECG criteria in diagnosis of acute myocardial infarction in the presence of left bundle branch block. Int J Cardiol. 2001;78:167–74. CrossRefPubMed Gunnarsson G, Eriksson P, Dellborg M. ECG criteria in diagnosis of acute myocardial infarction in the presence of left bundle branch block. Int J Cardiol. 2001;78:167–74. CrossRefPubMed
10.
Zurück zum Zitat Gunnarsson G, Eriksson P, Dellborg M. Continuous ST-segment monitoring of patients with right bundle branch block and suspicion of acute myocardial infarction. Ann Noninvasive Electrocardiol. 2005;10:161–8. CrossRefPubMed Gunnarsson G, Eriksson P, Dellborg M. Continuous ST-segment monitoring of patients with right bundle branch block and suspicion of acute myocardial infarction. Ann Noninvasive Electrocardiol. 2005;10:161–8. CrossRefPubMed
11.
Zurück zum Zitat Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G; National Kidney Foundation. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med. 2003;139:137–47. CrossRefPubMed Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MW, Hogg RJ, Perrone RD, Lau J, Eknoyan G; National Kidney Foundation. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med. 2003;139:137–47. CrossRefPubMed
12.
Zurück zum Zitat Rudski LG, Lai WW, Afilalo J, et al. 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. 2010;23(7):685–713. (quiz 86–8). CrossRefPubMed Rudski LG, Lai WW, Afilalo J, et al. 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. 2010;23(7):685–713. (quiz 86–8). CrossRefPubMed
13.
Zurück zum Zitat Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440–63. CrossRefPubMed Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440–63. CrossRefPubMed
14.
Zurück zum Zitat Yvorchuk KJ, Davies RA, Chan KL. Measurement of left ventricular ejection fraction by acoustic quantification and comparison with radionuclide angiography. Am J Cardiol. 1994;74(10):1052–6. CrossRefPubMed Yvorchuk KJ, Davies RA, Chan KL. Measurement of left ventricular ejection fraction by acoustic quantification and comparison with radionuclide angiography. Am J Cardiol. 1994;74(10):1052–6. CrossRefPubMed
15.
Zurück zum Zitat Spiropoulos K, Charokopos N, Petsas T, et al. Non-invasive estimation of pulmonary arterial hypertension in chronic obstructive pulmonary disease. Lung. 1999;177(2):65–75. CrossRefPubMed Spiropoulos K, Charokopos N, Petsas T, et al. Non-invasive estimation of pulmonary arterial hypertension in chronic obstructive pulmonary disease. Lung. 1999;177(2):65–75. CrossRefPubMed
16.
Zurück zum Zitat Pavlicek M, Wahl A, Rutz T, et al. Right ventricular systolic function assessment: rank of echocardiographic methods vs. cardiac magnetic resonance imaging. Eur J Echocardiogr. 2011;12(11):871–80. CrossRefPubMed Pavlicek M, Wahl A, Rutz T, et al. Right ventricular systolic function assessment: rank of echocardiographic methods vs. cardiac magnetic resonance imaging. Eur J Echocardiogr. 2011;12(11):871–80. CrossRefPubMed
17.
Zurück zum Zitat Popescu BA, Beladan CC, Calin A, et al. Left ventricular remodelling and torsional dynamics in dilated cardiomyopathy: reversed apical rotation as a marker of disease severity. Eur J Heart Fail. 2009;11(10):945–51. CrossRefPubMed Popescu BA, Beladan CC, Calin A, et al. Left ventricular remodelling and torsional dynamics in dilated cardiomyopathy: reversed apical rotation as a marker of disease severity. Eur J Heart Fail. 2009;11(10):945–51. CrossRefPubMed
18.
Zurück zum Zitat Leung DY, Ng AC. Emerging clinical role of strain imaging in echocardiography. Heart Lung Circ. 2010;19(3):161–74. CrossRefPubMed Leung DY, Ng AC. Emerging clinical role of strain imaging in echocardiography. Heart Lung Circ. 2010;19(3):161–74. CrossRefPubMed
19.
Zurück zum Zitat Blessberger H, Binder T. Two dimensional speckle tracking echocardiography: clinical applications. Heart. 2010;96(24):2032–40. CrossRefPubMed Blessberger H, Binder T. Two dimensional speckle tracking echocardiography: clinical applications. Heart. 2010;96(24):2032–40. CrossRefPubMed
20.
Zurück zum Zitat Spinarova L, Meluzin J, Toman J, Hude P, Krejci J, Vitovec J. Right ventricular dysfunction in chronic heart failure patients. Eur J Heart Fail. 2005;7(4):485–9. CrossRefPubMed Spinarova L, Meluzin J, Toman J, Hude P, Krejci J, Vitovec J. Right ventricular dysfunction in chronic heart failure patients. Eur J Heart Fail. 2005;7(4):485–9. CrossRefPubMed
21.
Zurück zum Zitat Tigen K, Karaahmet T, Cevik C, et al. Prognostic utility of right ventricular systolic functions assessed by tissue Doppler imaging in dilated cardiomyopathy and its correlation with plasma NT-pro-BNP levels. Congest Heart Fail. 2009;15(5):234–9. CrossRefPubMed Tigen K, Karaahmet T, Cevik C, et al. Prognostic utility of right ventricular systolic functions assessed by tissue Doppler imaging in dilated cardiomyopathy and its correlation with plasma NT-pro-BNP levels. Congest Heart Fail. 2009;15(5):234–9. CrossRefPubMed
22.
Zurück zum Zitat Guler A, Tigen KM, Dundar C, et al. Left atrial deformation and nonischemic dilated cardiomyopathy. A 2D speckle-tracking imaging study. Herz. 2014;39(2):251–7. CrossRefPubMed Guler A, Tigen KM, Dundar C, et al. Left atrial deformation and nonischemic dilated cardiomyopathy. A 2D speckle-tracking imaging study. Herz. 2014;39(2):251–7. CrossRefPubMed
23.
Zurück zum Zitat Bazaz R, Edelman K, Gulyasy B, López-Candales A. Evidence of robust coupling of atrioventricular mechanical function of the right side of the heart: insights from M-mode analysis of annular motion. Echocardiography. 2008;25(6):557–61. CrossRefPubMed Bazaz R, Edelman K, Gulyasy B, López-Candales A. Evidence of robust coupling of atrioventricular mechanical function of the right side of the heart: insights from M-mode analysis of annular motion. Echocardiography. 2008;25(6):557–61. CrossRefPubMed
24.
Zurück zum Zitat Padeletti M, Cameli M, Lisi M, et al. Right atrial speckle tracking analysis as a novel noninvasive method for pulmonary hemodynamics assessment in patients with chronic systolic heart failure. Echocardiography. 2011;28(6):658–64. CrossRefPubMed Padeletti M, Cameli M, Lisi M, et al. Right atrial speckle tracking analysis as a novel noninvasive method for pulmonary hemodynamics assessment in patients with chronic systolic heart failure. Echocardiography. 2011;28(6):658–64. CrossRefPubMed
25.
Zurück zum Zitat D’Andrea A, Scarafile R, Riegler L, et al. Right atrial size and deformation in patients with dilated cardiomyopathy undergoing cardiac resynchronization therapy. Eur J Heart Fail. 2009;11(12):1169–77. CrossRefPubMed D’Andrea A, Scarafile R, Riegler L, et al. Right atrial size and deformation in patients with dilated cardiomyopathy undergoing cardiac resynchronization therapy. Eur J Heart Fail. 2009;11(12):1169–77. CrossRefPubMed
26.
Zurück zum Zitat Barbosa MM, Rocha MO, Botoni FA, Ribeiro AL, Nunes MC. Is atrial function in Chagas dilated cardiomyopathy more impaired than in idiopathic dilated cardiomyopathy? Eur J Echocardiogr. 2011;12(9):643–7. CrossRefPubMed Barbosa MM, Rocha MO, Botoni FA, Ribeiro AL, Nunes MC. Is atrial function in Chagas dilated cardiomyopathy more impaired than in idiopathic dilated cardiomyopathy? Eur J Echocardiogr. 2011;12(9):643–7. CrossRefPubMed
27.
Zurück zum Zitat Schwarz K, Singh S, Dawson D, Frenneaux MP. Right ventricular function in left ventricular disease: pathophysiology and implications. Heart Lung Circ. 2013;22(7):507–11. CrossRefPubMed Schwarz K, Singh S, Dawson D, Frenneaux MP. Right ventricular function in left ventricular disease: pathophysiology and implications. Heart Lung Circ. 2013;22(7):507–11. CrossRefPubMed
28.
Zurück zum Zitat Chrysohoou C, Antoniou CK, Kotrogiannis I, et al. Role of right ventricular systolic function on long-term outcome in patients with newly diagnosed systolic heart failure. Circ J. 2011;75(9):2176–81. CrossRefPubMed Chrysohoou C, Antoniou CK, Kotrogiannis I, et al. Role of right ventricular systolic function on long-term outcome in patients with newly diagnosed systolic heart failure. Circ J. 2011;75(9):2176–81. CrossRefPubMed
29.
Zurück zum Zitat Gulati A, Ismail TF, Jabbour A, et al. The prevalence and prognostic significance of right ventricular systolic dysfunction in nonischemic dilated cardiomyopathy. Circulation. 2013;128(15):1623–33. CrossRefPubMed Gulati A, Ismail TF, Jabbour A, et al. The prevalence and prognostic significance of right ventricular systolic dysfunction in nonischemic dilated cardiomyopathy. Circulation. 2013;128(15):1623–33. CrossRefPubMed
30.
Zurück zum Zitat Yilmaz R, Gencer M, Ceylan E, Demirbag R. Impact of chronic obstructive pulmonary disease with pulmonary hypertension on both left ventricular systolic and diastolic performance. J Am Soc Echocardiogr. 2005;18(8):873–81. CrossRefPubMed Yilmaz R, Gencer M, Ceylan E, Demirbag R. Impact of chronic obstructive pulmonary disease with pulmonary hypertension on both left ventricular systolic and diastolic performance. J Am Soc Echocardiogr. 2005;18(8):873–81. CrossRefPubMed
31.
Zurück zum Zitat Gurudevan SV, Malouf PJ, Auger WR, et al. Abnormal left ventricular diastolic filling in chronic thromboembolic pulmonary hypertension: true diastolic dysfunction or left ventricular underfilling? J Am Coll Cardiol. 2007;49(12):1334–9. CrossRefPubMed Gurudevan SV, Malouf PJ, Auger WR, et al. Abnormal left ventricular diastolic filling in chronic thromboembolic pulmonary hypertension: true diastolic dysfunction or left ventricular underfilling? J Am Coll Cardiol. 2007;49(12):1334–9. CrossRefPubMed
32.
Zurück zum Zitat Colkesen Y, Acil T, Findikcioğlu A, et al. Tissue Doppler evaluation of the effects of major lung resection on cardiac functions. Turk Kardiyol Dern Ars. 2009;37(5):317–20. PubMed Colkesen Y, Acil T, Findikcioğlu A, et al. Tissue Doppler evaluation of the effects of major lung resection on cardiac functions. Turk Kardiyol Dern Ars. 2009;37(5):317–20. PubMed
Metadaten
Titel
Right ventricular and atrial functions in patients with nonischemic dilated cardiomyopathy
verfasst von
MD Assoc. Prof. Kursat Tigen
MD Assoc. Prof. Tansu Karaahmet
MD Cihan Dundar
MD Altug Cincin
MD Assoc. Prof. Beste Ozben
MD Ahmet Guler
MD Emre Gurel
MD Murat Sunbul
MD Prof. Yelda Basaran
Publikationsdatum
01.11.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 21-22/2015
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-015-0852-1