Exercise Doppler echocardiography (EDE) is a well-validated tool in ischemic and valvular heart diseases. However, its use in the assessment of the right heart and pulmonary circulation unit (RH-PCU) is limited. The aim of this study is to assess the semi-recumbent bicycle EDE feasibility for the evaluation of RH-PCU in a large multi-center population, from healthy individuals and elite athletes to patients with overt or at risk of developing pulmonary hypertension (PH). From January 2019 to July 2019, 954 subjects [mean age 54.2 ± 16.4 years, range 16–96, 430 women] underwent standardized semi-recumbent bicycle EDE with an incremental workload of 25 watts every 2 min, were prospectively enrolled among 7 centers participating to the RIGHT Heart International NETwork (RIGHT-NET). EDE parameters of right heart structure, function and pressures were obtained according to current recommendations. Right ventricular (RV) function at peak exercise was feasible in 903/940 (96%) by tricuspid annular plane systolic excursion (TAPSE), 667/751 (89%) by tissue Doppler-derived tricuspid lateral annular systolic velocity (S′) and 445/672 (66.2%) by right ventricular fractional area change (RVFAC). RV—right atrial pressure gradient [RV–RA gradient = 4 × tricuspid regurgitation velocity2 (TRV)] was feasible in 894/954 patients (93.7%) at rest and in 816/954 (85.5%) at peak exercise. The feasibility rate in estimating pulmonary artery pressure improved to more than 95%, if both TRV and/or right ventricular outflow tract acceleration time (RVOT AcT) were considered. In high specialized echocardiography laboratories semi-recumbent bicycle EDE is a feasible tool for the assessment of the RH-PCU pressure and function.
Feasibility of semi-recumbent bicycle exercise Doppler echocardiography for the evaluation of the right heart and pulmonary circulation unit in different clinical conditions: the RIGHT heart international NETwork (RIGHT-NET) / Ferrara, F.; Gargani, L.; Naeije, R.; Rudski, L.; Armstrong, W. F.; Wierzbowska-Drabik, K.; Argiento, P.; Bandera, F.; Cademartiri, F.; Citro, R.; Cittadini, A.; Cocchia, R.; Contaldi, C.; D'Alto, M.; D'Andrea, A.; Grunig, E.; Guazzi, M.; Kolias, T. J.; Limongelli, G.; Marra, A. M.; Mauro, C.; Moreo, A.; Ranieri, B.; Saggar, R.; Salzano, A.; Stanziola, A. A.; Vriz, O.; Vannan, M.; Kasprzak, J. D.; Bossone, E.; Capuano, F.; Benvenga, R.; Bellino, M.; Radano, I.; Marra, A.; D'Assante, R.; Rega, S.; Mazzola, M.; Raciti, M.; Dellegrottaglie, S.; De Luca, N.; Rozza, F.; Russo, V.; Di Salvo, G.; Ghio, S.; Guida, S.; Grunig, E.; Eichstaedt, C. A.; Labate, V.; La Gerche, A.; Pacileo, G.; Verrengia, M.; Kovacs, G.; Douschan, P.; Casadei, F.; De Chiara, B.; Ostenfeld, E.; Pedrizzetti, G.; Pieri, F.; Mori, F.; Moggi-Pignone, A.; Pratali, L.; Pugliese, N.; Saggar, R.; Selton-Suty, C.; Huttin, O.; Venner, C.; Serra, W.; Tafuni, F.; Stanziola, A.; Martino, M.; Caccavo, G.; Szabo, I.; Varga, A.; Agoston, G.; Voilliot, D.; Mobasseri, S.; Flueckiger, P.; Liu, S.. - In: THE INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING. - ISSN 1569-5794. - 37:7(2021), pp. 2151-2167. [10.1007/s10554-021-02243-x]
Feasibility of semi-recumbent bicycle exercise Doppler echocardiography for the evaluation of the right heart and pulmonary circulation unit in different clinical conditions: the RIGHT heart international NETwork (RIGHT-NET)
Citro R.;Cittadini A.;Contaldi C.;Limongelli G.;Marra A. M.;Salzano A.;Stanziola A. A.;Bossone E.;D'Assante R.;Rega S.;Dellegrottaglie S.;De Luca N.;Rozza F.;Pugliese N.;Stanziola A.;Caccavo G.;
2021
Abstract
Exercise Doppler echocardiography (EDE) is a well-validated tool in ischemic and valvular heart diseases. However, its use in the assessment of the right heart and pulmonary circulation unit (RH-PCU) is limited. The aim of this study is to assess the semi-recumbent bicycle EDE feasibility for the evaluation of RH-PCU in a large multi-center population, from healthy individuals and elite athletes to patients with overt or at risk of developing pulmonary hypertension (PH). From January 2019 to July 2019, 954 subjects [mean age 54.2 ± 16.4 years, range 16–96, 430 women] underwent standardized semi-recumbent bicycle EDE with an incremental workload of 25 watts every 2 min, were prospectively enrolled among 7 centers participating to the RIGHT Heart International NETwork (RIGHT-NET). EDE parameters of right heart structure, function and pressures were obtained according to current recommendations. Right ventricular (RV) function at peak exercise was feasible in 903/940 (96%) by tricuspid annular plane systolic excursion (TAPSE), 667/751 (89%) by tissue Doppler-derived tricuspid lateral annular systolic velocity (S′) and 445/672 (66.2%) by right ventricular fractional area change (RVFAC). RV—right atrial pressure gradient [RV–RA gradient = 4 × tricuspid regurgitation velocity2 (TRV)] was feasible in 894/954 patients (93.7%) at rest and in 816/954 (85.5%) at peak exercise. The feasibility rate in estimating pulmonary artery pressure improved to more than 95%, if both TRV and/or right ventricular outflow tract acceleration time (RVOT AcT) were considered. In high specialized echocardiography laboratories semi-recumbent bicycle EDE is a feasible tool for the assessment of the RH-PCU pressure and function.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
