Underfilling decreases left ventricular function in pulmonary arterial hypertension
Sjögren, Hannah ; Kjellström, Barbro LU ; Bredfelt, Anna ; Steding-Ehrenborg, Katarina LU ; Rådegran, Göran LU ; Hesselstrand, Roger LU ; Arheden, Håkan LU and Ostenfeld, Ellen LU
(2021)
In International Journal of Cardiovascular Imaging
37(5).
p.1745-1755
- Abstract
To evaluate the association between impaired left ventricular (LV) longitudinal function and LV underfilling in patients with pulmonary arterial hypertension (PAH). Thirty-nine patients with PAH and 18 age and sex-matched healthy controls were included. LV volume and left atrial volume (LAV) were delineated in short-axis cardiac magnetic resonance (CMR) cine images. LV longitudinal function was assessed from atrio-ventricular plane displacement (AVPD) and global longitudinal strain (GLS) was assessed using feature tracking in three long-axis views. LV filling was assessed by LAV and by pulmonary artery wedge pressure (PAWP) using right heart catheterisation. Patients had a smaller LAV, LV volume and stroke volume as well as a lower... (More)
To evaluate the association between impaired left ventricular (LV) longitudinal function and LV underfilling in patients with pulmonary arterial hypertension (PAH). Thirty-nine patients with PAH and 18 age and sex-matched healthy controls were included. LV volume and left atrial volume (LAV) were delineated in short-axis cardiac magnetic resonance (CMR) cine images. LV longitudinal function was assessed from atrio-ventricular plane displacement (AVPD) and global longitudinal strain (GLS) was assessed using feature tracking in three long-axis views. LV filling was assessed by LAV and by pulmonary artery wedge pressure (PAWP) using right heart catheterisation. Patients had a smaller LAV, LV volume and stroke volume as well as a lower LV-AVPD and LV-GLS than controls. PAWP was 6 [IQR 5––9] mmHg in patients. LV ejection fraction did not differ between groups. LV stroke volume correlated with LV-AVPD (r = 0.445, p =.001), LV-GLS (r = − 0.549, p < 0.0001) and LAVmax (r =.585, p < 0.0001). Furthermore, LV-AVPD (r =.598) and LV-GLS (r = − 0.675) correlated with LAVmax (p < 0.0001 for both). Neither LV-AVPD, LV-GLS, LAVmax nor stroke volume correlated with PAWP. Impaired LV longitudinal function was associated with low stroke volume, low PAWP and a small LAV in PAH. Small stroke volumes and LAV, together with normal LA pressure, implies that the mechanism causing reduced LV longitudinal function is underfilling rather than an intrinsic LV dysfunction in PAH.
(Less)
- author
- Sjögren, Hannah
; Kjellström, Barbro
LU
; Bredfelt, Anna
; Steding-Ehrenborg, Katarina
LU
; Rådegran, Göran
LU
; Hesselstrand, Roger
LU
; Arheden, Håkan
LU
and Ostenfeld, Ellen
LU
- organization
- publishing date
- 2021-05-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Cardiac magnetic resonance imaging, Feature tracking strain, Left atrial volume, Left ventricular dysfunction, Pulmonary hypertension
- in
- International Journal of Cardiovascular Imaging
- volume
- 37
- issue
- 5
- pages
- 11 pages
- publisher
- Springer
- external identifiers
-
- pmid:33502652
- scopus:85099921845
- ISSN
- 1569-5794
- DOI
- 10.1007/s10554-020-02143-6
- language
- English
- LU publication?
- yes
- id
- 04488280-650c-41ea-afff-0158b8be00f0
- date added to LUP
- 2021-02-08 10:41:14
- date last changed
- 2025-02-07 07:22:47
@article{04488280-650c-41ea-afff-0158b8be00f0,
abstract = {{<p>To evaluate the association between impaired left ventricular (LV) longitudinal function and LV underfilling in patients with pulmonary arterial hypertension (PAH). Thirty-nine patients with PAH and 18 age and sex-matched healthy controls were included. LV volume and left atrial volume (LAV) were delineated in short-axis cardiac magnetic resonance (CMR) cine images. LV longitudinal function was assessed from atrio-ventricular plane displacement (AVPD) and global longitudinal strain (GLS) was assessed using feature tracking in three long-axis views. LV filling was assessed by LAV and by pulmonary artery wedge pressure (PAWP) using right heart catheterisation. Patients had a smaller LAV, LV volume and stroke volume as well as a lower LV-AVPD and LV-GLS than controls. PAWP was 6 [IQR 5––9] mmHg in patients. LV ejection fraction did not differ between groups. LV stroke volume correlated with LV-AVPD (r = 0.445, p =.001), LV-GLS (r = − 0.549, p < 0.0001) and LAVmax (r =.585, p < 0.0001). Furthermore, LV-AVPD (r =.598) and LV-GLS (r = − 0.675) correlated with LAVmax (p < 0.0001 for both). Neither LV-AVPD, LV-GLS, LAVmax nor stroke volume correlated with PAWP. Impaired LV longitudinal function was associated with low stroke volume, low PAWP and a small LAV in PAH. Small stroke volumes and LAV, together with normal LA pressure, implies that the mechanism causing reduced LV longitudinal function is underfilling rather than an intrinsic LV dysfunction in PAH.</p>}},
author = {{Sjögren, Hannah and Kjellström, Barbro and Bredfelt, Anna and Steding-Ehrenborg, Katarina and Rådegran, Göran and Hesselstrand, Roger and Arheden, Håkan and Ostenfeld, Ellen}},
issn = {{1569-5794}},
keywords = {{Cardiac magnetic resonance imaging; Feature tracking strain; Left atrial volume; Left ventricular dysfunction; Pulmonary hypertension}},
language = {{eng}},
month = {{05}},
number = {{5}},
pages = {{1745--1755}},
publisher = {{Springer}},
series = {{International Journal of Cardiovascular Imaging}},
title = {{Underfilling decreases left ventricular function in pulmonary arterial hypertension}},
url = {{http://dx.doi.org/10.1007/s10554-020-02143-6}},
doi = {{10.1007/s10554-020-02143-6}},
volume = {{37}},
year = {{2021}},
}