IMR Press / RCM / Volume 24 / Issue 12 / DOI: 10.31083/j.rcm2412366
Open Access Original Research
Assessment of Right Ventricular-Arterial Coupling by Echocardiography in Patients with Right Ventricular Pressure and Volume Overload
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1 Department of Ultrasound, the First Affiliated Hospital of Wenzhou Medical University, 325000 Wenzhou, Zhejiang, China
2 Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, 325000 Wenzhou, Zhejiang, China
3 Department of Cardiovascular Surgery, the First Affiliated Hospital of Wenzhou Medical University, 325000 Wenzhou, Zhejiang, China
*Correspondence: lshsh303@sina.com (Shusheng Liao)
Rev. Cardiovasc. Med. 2023, 24(12), 366; https://doi.org/10.31083/j.rcm2412366
Submitted: 13 June 2023 | Revised: 4 August 2023 | Accepted: 23 August 2023 | Published: 25 December 2023
(This article belongs to the Section Cardiovascular Imaging)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Right ventricle-pulmonary arterial (RV-PA) coupling is considered the gold standard for assessing right ventricular (RV) function and can be evaluated noninvasively by echocardiography. The ratios of tricuspid annular plane systolic excursion/pulmonary artery systolic pressure (TAPSE/PASP), RV global longitudinal strain (G-RVLS)/PASP, and stroke volume/end-systolic volume (SV/ESV) have been proposed as surrogates of RV-PA coupling. The relationship of these parameters remains incompletely understood in patients with volume and pressure loading conditions. We aimed to compare these parameters and evaluate their relationship with 3D RV data in patients with RV pressure and volume overload. Methods: This study was performed on 110 individuals who underwent 2D and 3D echocardiography. Fifty-four patients had RV volume overload (atrial septal defect (ASD) group), 34 patients had RV pressure overload (pulmonary hypertension (PH) group), and 22 were controls. TAPSE/PASP, G-RVLS/PASP and SV/ESV ratios were calculated. Correlations between parameters of RV-PA coupling and 3D data were assessed using general linear mixed models. Results: Compared with the ASD group, the PH group had lower TAPSE/PASP and G-RVLS/PASP ratios. The SV/ESV ratio had a strong correlation with right ventricle ejection fraction (RVEF) in both ASD and PH patients (r = 0.8703, p < 0.001 and r = 0.9388, p < 0.001, respectively). The G-RVLS/PASP ratio showed a strong or moderately negative relationship with end-diastolic volume (EDV), ESV and SV (r = –0.7768, p = 0.001; r = –0.7327, p = 0.0005 and r = –0.6816, p = 0.0018, respectively) in PH patients. The TAPSE/PASP ratio showed moderately negative correlations with EDV and ESV (r = –0.5712, p = 0.0012 and r = –0.5594, p = 0.0016, respectively) in PH patients. Conclusions: Non-invasive RV-PA coupling parameters derived from echocardiography appear similar, but not identical to profiles in pressure-overloaded and volume-overloaded patients. The correlations between non-invasive RV-PA coupling parameters and 3D data displayed various degrees of correlation.

Keywords
echocardiography
3D
pulmonary hypertension
right ventricle-arterial coupling
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