Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

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, Francesco and Bossone, Eduardo (2021) In International Journal of Cardiovascular Imaging 37(7). p.2151-2167
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... (More)

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.

(Less)
Please use this url to cite or link to this publication:
author
and
contributor
LU orcid
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adolescent, Adult, Aged, Aged, 80 and over, Bicycling, Echocardiography, Doppler, Feasibility Studies, Female, Humans, Middle Aged, Predictive Value of Tests, Pulmonary Circulation, Ventricular Dysfunction, Right, Ventricular Function, Right, Young Adult
in
International Journal of Cardiovascular Imaging
volume
37
issue
7
pages
2151 - 2167
publisher
Springer
external identifiers
  • pmid:33866467
  • scopus:85106241131
ISSN
1875-8312
DOI
10.1007/s10554-021-02243-x
language
English
LU publication?
yes
additional info
© 2021. The Author(s), under exclusive licence to Springer Nature B.V.
id
34a90708-0224-4967-9ec1-c6a637fbda2a
date added to LUP
2022-03-16 11:11:53
date last changed
2024-04-13 15:35:29
@article{34a90708-0224-4967-9ec1-c6a637fbda2a,
  abstract     = {{<p>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.</p>}},
  author       = {{Ferrara, Francesco and Bossone, Eduardo}},
  issn         = {{1875-8312}},
  keywords     = {{Adolescent; Adult; Aged; Aged, 80 and over; Bicycling; Echocardiography, Doppler; Feasibility Studies; Female; Humans; Middle Aged; Predictive Value of Tests; Pulmonary Circulation; Ventricular Dysfunction, Right; Ventricular Function, Right; Young Adult}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{2151--2167}},
  publisher    = {{Springer}},
  series       = {{International Journal of Cardiovascular Imaging}},
  title        = {{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)}},
  url          = {{http://dx.doi.org/10.1007/s10554-021-02243-x}},
  doi          = {{10.1007/s10554-021-02243-x}},
  volume       = {{37}},
  year         = {{2021}},
}