{Author 1 (Prefix):11.2} {Author 1 (Last):11.6}

TitelRight Ventricular Wall Tension in the Assessment of Pediatric Pulmonary Arterial Hypertension
Einleitung

Echocardiographic determination of the right ventricular wall-tension (RVWT) is a novel parameter for the assessment of pulmonary hypertension (PH) in adults. We aimed to investigate RVWT in pediatric PH patients, and to correlate RVWT data with invasively obtained hemodynamics, echocardiographic variables, NT-proBNP, and NYHA functional class (FC).

Patient/en und Methoden

Prospective echocardiographic study in two independent cohorts of children with PH and age-and gender-matched control subjects (Pediatric PH patients: n=49; matched controls: n=49).

Ergebnisse

RVWT was increased in children with PH as compared to healthy controls (p<0.01). Higher RVWT values were associated with less favorable invasive hemodynamics, i.e. increased mean pulmonary artery pressure (mPAP) and pulmonary to systemic vascular resistance ratio (PVR/SVR). RVWT values also increased with worsening NYHA-FC and increasing plasma NT-pro-BNP levels. In addition, RVWT values correlated with other echocardiographic variables, such as pulmonary artery acceleration time (PAAT), tricuspid annular peak systolic excursion (TAPSE), RV/LV dimension ratio, and left ventricular eccentricity index (LVEI).

Schlussfolgerung/Diskussion

RVWT is a novel and easily obtained bedside indicator of RV remodeling and dilatation. Higher RVWT values were associated with lower FC, and worse hemodynamics, demonstrating that this index provides additional information on right ventricular performance in the setting of increased RV pressure load in pediatric PH.

Autor*in 1Martin Koestenberger Division of Pediatric Cardiology, Medical University Graz, Austria
Autor*in 2Peter Kramer Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany
Autor*in 3Alexander Avian Institute for Medical Informatics, Statistics and Documentation, Medical University Graz, Austria
Autor*in 4Andreas Gamillscheg Division of Pediatric Cardiology, Medical University Graz, Graz, Austria
Autor*in 5Gerhard Cvirn Physiological Chemistry Division, Otto Loewi Research Center, Medical University Graz, Graz, Austria
Autor*in 6Stefan Kurath-Koller Division of Pediatric Cardiology, Medical University Graz, Austria
Autor*in 7Sabrina Schweintzger Division of Pediatric Cardiology, Medical University Graz, Austria
Autor*in 8Massimilliano Cantinotti Fondazione Consiglio Nazionale delle Ricerche Area (CNR)-Regione Toscana G. Monasterio (FTGM), Pisa, Italy
Autor*in 9Felix Berger Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany
Autor*in 10Hannes Sallmon Department of Congenital Heart Disease/Pediatric Cardiology, Deutsches Herzzentrum Berlin (DHZB), Berlin, Germany