5026Six-segments right ventricular global longitudinal strain predicts survival in patients with pulmonary hypertension receiving specific vasodilator therapy

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In patients with pulmonary hypertension (PH) right ventricular (RV) function is a well-recognized determinant of clinical outcome. There are different RV function parameters used to predict outcome in patients with PH. Data regarding the prognostic value of RV global longitudinal strain (RV-GLS) assessed as averaged six-segments RV longitudinal strain in patients with PH patients are scarce. Purpose: To assess the predictive value of six-segments RV-GLS in PH patients receiving specific vasodilator therapy using 2D speckle-tracking echocardiography. Methods: Forty-seven patients (40±15 years, 36 women) with PH (13 with idiopathic pulmonary arterial hypertension (PAH), 17 with congenital heart disease, 6 with connective tissue disease, 6 with chronic thromboembolic PH and 5 with other forms of PAH) treated with either bosentan, sildenafil, or both and 33 healthy volunteers with similar age and gender (40±11 years, 21 women) were studied. Clinical parameters and biologic (B-type natriuretic peptide, BNP), invasive (RV and pulmonary artery pressures measured by right heart catheterization) and echocardiographic parameters of RV function (TAPSE, tissue-Doppler imaging-derived free-RV wall S- and e'-wave, RV fractional area change (FAC), Tei index, I/H, RV isovolumic acceleration-IVA) were assessed. RV global longitudinal strain (RV-GLS) was measured from the apical 4-chamber view as the average of six segments by speckle-tracking echocardiography. Parameters of pulmonary artery stiffness (PAS) were assessed: pulsatility, capacitance, elastic modulus, dynamic compliance. PH patients were followed-up for 23 months (2–49). An endpoint of cardiac death was defined.

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