When it all comes down to pressure: right ventricular ejection fraction at cardiac catheterisation

In the present issue of the European Respiratory Journal, Heerdt et al. [1] report on the validation of right ventricularejection fraction (RVEF) calculated from a pressure curve at cardiac catheterisation. This is of great interest as right ventricular (RV) function is the main determinant of symptomatology and outcome in pulmonary hypertension [2], and RVEF accordingly adds significantly to risk stratification in these patients [3]. However, ejection fraction (EF) is a ratio of stroke volume (SV) to end-diastolic volume (EDV), with no pressure in the equation. So, how is it possible to calculate a volume ratio from pressure measurements?
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Editorials Source Type: research

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Abstract BACKGROUND: Pulmonary hypertension (PH) adversely impact patient´s exercise capacity in interstitial lung disease (ILD). Pulmonary vascular and right ventricular (RV) dysfunction impact, however, have traditionally been thought to be mild, and clinically relevant principally in advanced lung disease states. We sought to evaluate the relative contributions of pulmonary mechanics, pulmonary vascular and RV function to the ILD exercise limit. METHODS: 49 ILD patients that underwent resting right heart catheterization followed by invasive exercise testing were evaluated. Patients with PH at rest (I...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Authors: Toroghi HM, Lo KB, Ziccardi MR, Horn B, Kanjanahattakij N, Malik E, Penalver J, Rangaswami J, Gupta S, Amanullah A Abstract Worsening renal function in patients with heart failure with preserved ejection fraction is associated with poor outcomes. Pulmonary arterial capacitance is a novel right heart catheterization derived hemodynamic metric representing pulmonary arterial tree distensibility and right ventricle afterload. Given the strong association between heart failure, pulmonary hypertension, and kidney function, the goal of this study is to investigate the correlation between Pulmonary arterial capac...
Source: Reviews in Cardiovascular Medicine - Category: Cardiology Tags: Rev Cardiovasc Med Source Type: research
CONCLUSIONS: BPA performed in a CTEPH expert centre is an effective and safe treatment in patients with inoperable CTEPH. PMID: 31782109 [PubMed - as supplied by publisher]
Source: Netherlands Heart Journal - Category: Cardiology Authors: Tags: Neth Heart J Source Type: research
Conclusion: MnTBAP treatment can partly reverse RV afterload and pulmonary vascular remodeling in established experimental PAH. Together with the improved cardiac function, MnTBAP may be a promising intervention for PAH.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research
Aims and objective: The cardinal symptom of pulmonary hypertension (PH) is dyspnea on exertion, which may lead to decreased activity in daily living. The aim of this study was to analyze daily physical activity in incident patients with arterial or chronic thromboembolic PH (PAH/CTEPH) and to investigate its correlation with pulmonary hemodynamics, symptoms, exercise capacity and other outcomes.Methods: Incident patients with PAH/CTEPH had a one-week activity assessment by the arm-worn accelerometer SenseWear within -3m/+2w of the diagnostic right heart catheterization (RHC) and baseline assessments including 6-minute walk...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research
Vena cava backflow is a well-recognised clinical hallmark of right ventricular failure in pulmonary arterial hypertension (PAH). Backflow may result from tricuspid regurgitation during right ventricular systole or from impaired right ventricular diastolic filling during atrial contraction. Our aim was to quantify the forward and backward flow in the vena cava and to establish the main cause in PAH. In 62 PAH patients, cardiac magnetic resonance measurements provided volumetric flows (mL·s–1) in the superior and inferior vena cava; time integration of flow gave volume. The "backward fraction" was defi...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary vascular disease Original Articles: Pulmonary hypertension Source Type: research
ConclusionsBPA significantly improves cardiopulmonary hemodynamics with an acceptable safety profile. Further studies assessing the long-term efficacy of BPA are required.
Source: Journal of Vascular and Interventional Radiology - Category: Radiology Source Type: research
AbstractIntroductionThe cardinal symptom of pulmonary hypertension (PH) is dyspnea on exertion, leading to decreased activity in daily living. The aim of this study was to analyze daily physical activity in incident patients with arterial or chronic thromboembolic PH (PAH/CTEPH) and to investigate its correlation with pulmonary hemodynamics, symptoms, exercise capacity, and other outcomes.MethodsIncident patients with PAH/CTEPH had a 1-week activity assessment by the arm-worn accelerometer SenseWear within − 3 months/+ 2 weeks of the diagnostic right heart catheterization (RHC) and baseline as...
Source: Lung - Category: Respiratory Medicine Source Type: research
AbstractA growing body of evidence has demonstrated that pulmonary arterial capacitance (PAC) is the strongest hemodynamic predictor of clinical outcomes across a wide spectrum of cardiovascular disease, including pulmonary hypertension and heart failure. We hypothesized that a ratio of right ventricular stroke volume (RVOT VTI) to the associated peak arterial systolic pressure (PASP) could function as a reliable non-invasive surrogate for PAC. We performed a prospective study of patients undergoing simultaneous transthoracic echocardiography and right heart catheterization (RHC) for various clinical indications. Measureme...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
The objective of this prospective study was to evaluate right ventricular function and pulmonary arterial compliance (PAC=stroke volume/pulse pressure) at rest and during exercise in patients with systemic sclerosis (SSc) with normal mean pulmonary artery pressures (mPAP) at rest, mildly elevated mPAP (mPAP 21 ‐24mmHg) and manifest pulmonary hypertension (mPAP≥25mmHg).MethodsPatients with SSc (n=112) underwent clinical assessment and right heart catheterization at rest and during exercise and were divided into three groups according to their resting mPAP values: normal mPAP ( ≤20mmHg), mildly elevated mPAP (21‐24...
Source: Arthritis and Rheumatology - Category: Rheumatology Authors: Tags: Full Length Source Type: research
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