Echocardiographic Assessment of Right Ventricle Dimensions and Function After Exposure to Extreme Altitude: Is an Expedition to 8000 m Hazardous for Right Ventricular Function?

2017 ◽  
Vol 18 (4) ◽  
pp. 330-337 ◽  
Author(s):  
Marta Kurdziel ◽  
Jarosław Wasilewski ◽  
Karolina Gierszewska ◽  
Anna Kazik ◽  
Gracjan Pytel ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Extreme Altitude ◽  
Echocardiographic Assessment ◽  
And Function

Echocardiographic assessment with right ventricular function improvement following ultrasound-accelerated catheter-directed thrombolytic therapy in submassive pulmonary embolism

Vascular ◽  
2017 ◽  
Vol 26 (3) ◽  
pp. 271-277 ◽  
Author(s):  
Charles Doheny ◽  
Lorena Gonzalez ◽  
Stanley M Duchman ◽  
Joseph Varon ◽  
Carlos F Bechara ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Left Ventricle ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Right Ventricular Dysfunction ◽  
Submassive Pulmonary Embolism ◽  
Echocardiographic Assessment

Introduction The objective of this study was to evaluate the efficacy of ultrasound-accelerated catheter-directed thrombolytic therapy in patients with submassive pulmonary embolism. Methods Clinical records of 46 patients with submassive pulmonary embolism who underwent ultrasound-accelerated catheter-directed pulmonary thrombolysis using tissue plasminogen activator, from 2007 to 2017, were analyzed. All patients experienced clinical symptoms with computed tomography evidence of pulmonary thrombus burden. Right ventricular dysfunction was present in all patients by echocardiographic finding of right ventricle-to-left ventricle ratio > 0.9. Treatment outcome, procedural complications, right ventricular pressures, and thrombus clearance were evaluated. Follow-up evaluation included echocardiographic assessment of right ventricle-to-left ventricle ratio at one month, six months, and one year. Results Technical success was achieved in all patients ( n = 46, 100%). Our patients received an average of 18.4 ± 4.7 mg of tissue plasminogen activator using ultrasound-accelerated thrombolytic catheter with an average infusion time of 16.5± 5.4 h. Clinical success was achieved in all patients (100%). Significant reduction of mean pulmonary artery pressure occurred following the treatment, which decreased from 36 ± 8 to 21 ± 5 mmHg ( p < 0.001). There were no major bleeding complications. All-cause mortality at 30 days was 0%. No patient developed recurrent pulmonary embolism during follow-up. During the follow-up period, 43 patients (93%) showed improvement of right ventricular dysfunction based on echocardiographic assessment. The right ventricle-to-left ventricle ratio decreased from 1.32 ± 0.18 to 0.91 ± 0.13 at the time of hospital discharge ( p < 0.01). The right ventricular function remained improved at 6 months and 12 months of follow-up, as right ventricle-to-left ventricle ratio were 0.92 ± 0.14 ( p < 0.01) and 0.91 ± 0.15 ( p < 0.01), respectively. Conclusion Ultrasound-accelerated catheter-directed thrombolysis is a safe and efficacious treatment for submassive pulmonary embolism. It reduces pulmonary hypertension and improves right ventricular function in patients with submassive pulmonary embolism.

scholarly journals Echocardiographic assessment of right ventricular function: current clinical practice

2018 ◽  
Vol 35 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Matthias Schneider ◽  
Stefan Aschauer ◽  
Julia Mascherbauer ◽  
Hong Ran ◽  
Christina Binder ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Current Clinical Practice ◽  
Echocardiographic Assessment

P1678Feasibility of comprehensive multi-plane echocardiographic evaluation of right ventricular function pre-LVAD implantation - preliminary results from a single centre experience

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D J Bowen ◽  
Y C Yalcin ◽  
M Strachinaru ◽  
J S McGhie ◽  
A E Van Den Bosch ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Advanced Heart Failure ◽  
Free Wall ◽  
Heart Failure Patients ◽  
Echocardiographic Evaluation ◽  
The Right

Abstract Introduction Right sided heart failure (RVF) is recognized as a major cause of morbidity and mortality after left ventricular assist device (LVAD) implantation. Despite the publication of several risk scores and predication models, identifying patients at risk for RVF after LVAD implantation remains a challenge. The right ventricle is complex in structure and not possible to fully assess from one echocardiographic 2D plane. Our centre previously introduced a novel multi-plane approach whereby four different RV free wall segments (lateral, anterior, inferior and inferior coronal – figure 1) can be imaged from the same echocardiographic position using electronic plane rotation. Purpose The aim of the study was to determine the feasibility of using multi-plane echocardiography to quantify right ventricular function in a small cohort of advanced heart failure patients prior to LVAD implantation. Methods Twelve advanced heart failure patients underwent detailed RV assessment by multi-plane echocardiography prior to LVAD implantation (median -15 [6.3–29.8] days before). Feasibility and values of the established RV functional echo parameters tricuspid annular plane systolic excursion (TAPSE) and tissue Doppler imaging derived tricuspid annular peak systolic velocity (TDI S') were assessed by an experienced sonographer on each of the 4 free wall segments. Mean values were calculated from an average of 3 measurements. Conventional 2D echo parameters and clinical outcome data post LVAD implantation were also collected. Results Feasibility of TAPSE and TDI measurements in all four RV free wall segments was 100%, with the exception of the inferior coronal wall (91.7% – TDI S' only). Mean 4 wall averaged TAPSE was 13.9±5.1mm, whilst mean TDI S' was 9.4±2.6cm/s. Mean TAPSE and TDI values were lower in the inferior and inferior coronal walls (13.3±5.8mm; 8.8±3.1cm/s and 10.9±5.7mm; 8.9±3.7cm/s) than those of the lateral and anterior walls (15.6±5.1mm; 9.9±2.3cm/s and 15.9±5.1mm; 10.1±2.6cm/s). The cohort was split by using a four wall averaged TAPSE value of 16mm as a cutoff. Mean 4 wall averaged TAPSE was 20.6±1.9mm in the >16mm group compared to 10.5±1.7mm for the <16mm group, whilst mean TDI S' was 9.4±2.6cm/s vs 7.7±0.7cm/s. Post LVAD implantation, there were 3 (25%) deaths and 6 (50%) incidences of acute kidney injury. Median length of stay in ICU and hospital was 4 (1–13.5) and 42.5 (30.3–65) days respectively. The <16mm group had higher incidences of negative outcomes and longer stay in both ICU and hospital following LVAD implantation (p: 0.07). Conclusion Multi-plane echocardiographic evaluation of the right ventricle appears feasible in advanced heart failure with potential for a more comprehensive quantification of right ventricular function pre-LVAD implantation. Larger, ideally multi-centre studies are required to further assess these preliminary findings.

scholarly journals Evaluation of right ventricle pulmonary artery coupling on right ventricular function in post operative tetralogy of Fallot patients underwent for pulmonary valve replacement

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Bhushan Sandeep ◽  
Xin Huang ◽  
Yuan Li ◽  
Xiaowei Wang ◽  
Long Mao ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Pulmonary Valve ◽  
Primary Repair ◽  
Pulmonary Valve Replacement ◽  
Rv Function

Abstract Background To evaluate RV-PA coupling in post operative TOF patients with ventricular dilatation underwent for PVR and investigate the correlation between ventricular functions measuring Ea/Emax ratio using cardio magnetic resonance and the effect of surgical type at primary repair of TOF on coupling. Method RV-PA coupling was measured noninvasively by Ea/Emax ratio from CMRI and ECHO. From CMRI results the patients were divided in two groups, RV-PA coupling and RV-PA uncoupling. Ea/Emax ≤1 was considered for coupling patients and Ea/Emax > 1 for uncoupling patients. Results Ninety patients were uncoupled (Ea/Emax: 1.55 ± 0.46) and 45 were coupled (Ea/Emax: 0.81 ± 0.15). Out of 75 TAP repaired patients 60 were uncoupled RV-PV. In addition, higher pro-BNP is an important factor for uncoupled RV-PV (P = 0.001). CMR evaluation for right ventricular function between uncoupling and coupling were RVEDVi (196.65 ± 63.57 vs. 154.28 ± 50.07, P = 0.001), RVESVi (121.19 ± 51.47 vs. 83.94 ± 20.43, P = 0.001), RVSVi (67.19 ± 19.87 vs. 106.31 ± 33.44, P = 0.001), and RVEF (40.90 ± 8.73 vs. 54.63 ± 4.76, P = 0.001). The increased RVEDVi, RVESVi and RVSVi and decreased RVEF have significant correlation with Ea/Emax. Ea/Emax was also found positively correlated with RVEDVi (P = < 0.05, r = 0.35), RVESVi (P = < 0.001, r = 0.41) and negatively correlated with RVSVi (P = < 0.05, r = 0.22) and RVEF (P = < 0.05, r = 0.78). Conclusions Unfavorable RV-PA coupling is present in post operative TOF patients and it is affected by several factors. Our results explain a new concept of RV-PA interactions as a contributing mechanism for the observed decline in RV function.

Sign in / Sign up

Export Citation Format

Share Document