Pneumologie 2019; 73(S 01)
DOI: 10.1055/s-0039-1677985
Freie Vorträge (FV DGP 4) – Sektion Kardiorespiratorische Interaktion
Kardiorespiratorische Interaktion: Imaging und Functioning
Georg Thieme Verlag KG Stuttgart · New York

Right heart size and function significantly correlate in patients with pulmonary arterial hypertension – a cross-sectional study

L Fischer
1   Thoraxklinik Heidelberg
,
N Benjamin
2   Zentrum für Pulmonale Hypertonie; Thoraxklinik am Universitätsklinikum Heidelberg; Translational Lung Research Centre Heidelberg (Tlrc), German Centre for Lung Research (Dzl)
,
N Blank
3   Medizinische Klinik V, Universitätsklinikum Heidelberg
,
B Egenlauf
4   Pneumologie und Beatmungsmedizin, Thoraxklinik am Universitätsklinikum Heidelberg; Zentrum für Pulmonale Hypertonie; Thoraxklinik Universitätsklinik Heidelberg
,
C Fischer
5   Institut für Humangenetik, Universität Heidelberg
,
S Harutyunova
6   Zentrum für Pulmonale Hypertonie, Thoraxklinik am Universitätsklinikum Heidelberg
,
M Koegler
1   Thoraxklinik Heidelberg
,
HM Lorenz
7   Universitätsklinikum Heidelberg, Innere Medizin V, Hämatologie, Onkologie und Rheumatologie, Medizinische Klinik
,
AM Marra
8   Centre for Pulmonary Hypertension at the Thoraxclinic, University Hospital Heidelberg, Heidelberg; Translational Lung Research Center Heidelberg (Tlrc), Member of the German Center for Lung Research (Dzl); Irccs Sdn, Naples Italy
,
C Nagel
1   Thoraxklinik Heidelberg
,
P Xanthouli
1   Thoraxklinik Heidelberg
,
E Bossone
9   “Cava De' Tirreni and Amalfi Coast” Hospital, University of Salerno
,
E Grünig
10   Lungenhochdruckzentrum der Thoraxklinik, Universitätsklinikum Heidelberg
› Author Affiliations
Further Information

Publication History

Publication Date:
19 February 2019 (online)

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    Background The objective of this study was to assess, whether right atrial (RA) and ventricular (RV) size is related to RV pump function at rest and during exercise in patients with pulmonary arterial hypertension (PAH).

    Methods We included 54 patients with invasively diagnosed PAH that had been stable on targeted medication. All patients underwent clinical assessments including right heart catheterization and echocardiography at rest and during exercise. RV output reserve was defined as increase of cardiac index (CI) from rest to peak exercise (ΔCIexercise). Patients were classified according to the median of RA and RV-area. RV pump function and further clinical parameters were compared between groups by studentʼs t-test. Uni- and multivariate Pearson correlation analyses were performed.

    Results Patients with larger RA and/or RV-areas (above a median of 16 and 20 cm2, respectively) showed significantly lower ΔCIexercise, higher mean pulmonary arterial pressure, pulmonary vascular resistance at rest and NT-proBNP levels. Furthermore, patients with higher RV-areas presented with a significantly lower RV stroke volume and pulmonary arterial compliance at peak exercise than patients with smaller RV-size. RV area was identified as the only independent predictor of RV output reserve.

    Conclusion RV and RA areas represent valuable and easily accessible indicators of RV pump function at rest and during exercise. Cardiac output reserve should be considered as an important clinical parameter. Prospective studies are needed for further evaluation.

    Key words Pulmonary Hypertension, right ventricular output reserve, pump function, right ventricular size, right atrial size


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