Evaluation of specle-traking echocardiography indicators in patients with idiopathic pulmonary arterial hypertension
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Abstract
The aim – to evaluate the diagnostic possibilities of using the method of speckle-tracking echocardiography (ST-Echo) in patients with idiopathic pulmonary arterial hypertension (IPAH) and to compare the results with a healthy population.
Materials and methods. The study included 27 patients with IPAH and 9 people who were in the control group. Both groups were comparable in age and sex. All patients underwent general clinical studies, biochemical blood tests to determine the level of N-terminal polypeptide of brain natriuretic hormone (NT-proBNP), 6-minute walk test, transthoracic and speckle-tracking echocardiography, Cardio-ankle vascular index (CAVI), right heart catheterization (RHC) using a Swan–Gantz catheter to determine central hemodynamic parameters.
Results and discussion. According to echocardiography, in patients with IPAH, TAPSE, FAC, RIMP and S‘ of the right ventricle were significantly worse than in the control group, and the rates of global longitudinal strain of the right (RV GLS) and left ventricles (LV GLS) and longitudinal strain rate of the right ventricle (RV GLSR). Using correlation analysis, it was found that the RV GLS was most strongly correlated, among others, with the distance (p<0.001) and blood oxygen saturation (p<0.05) according to the 6-minute walk test, NT-proBNP (p<0.001), systolic pulmonary artery pressure according to echocardiography (p<0.001) and CAVI (p<0.001). In contrast, the highest correlation with direct hemodynamic measurements was shown by two parameters: TAPSE – with cardiac index (p<0.05), pulmonary vascular resistance (PVR) (p<0.05), diastolic pressure in the pulmonary artery (p<0.05); and RIMP – with diastolic pulmonary artery pressure (p<0.001) and mean pulmonary artery pressure (p<0.05).
Conclusions. According to our results, we can conclude that a comprehensive assessment of RV function using transthoracic and ST-echocardiography allows a more individualized assessment of patients with IPAH. ST-Echo can be used in PH reference centers for initial examination and follow-up of such patients. ST-Echo is a complex and time-consuming study, so our data did not demonstrate the feasibility of using this technique in routine practice for the initial assessment of patients with suspected IPAH.
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