Right Ventricular Outflow Tract Velocity Time Interval: An Invaluable Yet Forgotten Echocardiographic Variable

IF 1.4 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques Pub Date : 2025-08-13 DOI:10.1111/echo.70239

Khalid Sawalha, Srikanth Vallurupalli, Angel López-Candales

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引用次数: 0

Abstract

Background

Echocardiographic examination of the right ventricular outflow tract (RVOT) has been invaluable in examining pulmonary artery (PA) flows and RV hemodynamics in response to increasing afterload. Currently, the TAPSE/PASP ratio is the preferred noninvasive variable for this assessment.

Methods

Our main aim was to determine the specific relationship that might exist between RVOT VTI Doppler measurements and TAPSE/PASP ratios across a wide range of different left ventricular (LV) ejection fractions and PASP values.

Results

Our study is the first to provide cutoff values for RVOT VTI according to the prevailing PA-RV hemodynamics. With TAPSE values >2 cm, normal RVOT VTI values should be >13 cm. However, when PASP or PVR are used in the metric analysis, RVOT VTI values >15 cm are, if PASP values <35 mmHg or PVR is <1.6 WU. Most interestingly, we found no correlation between RVOT VTI and the TAPSE/PASP ratio. Instead, the RVOT VTI/PVR ratio was very useful and appears as a potentially echocardiographic alternative to assess RV-PA coupling.

Discussion

Even when both TAPSE and RVOT VTI, as well as PASP and PVR, convey somewhat similar information, significant anatomical and functional differences exist between these variables. These differences might explain why the RVOT VTI/PVR ratio might be more useful than TAPSE/PASP, particularly given the limitations of using TAPSE in certain clinical scenarios and the more reliable hemodynamic data provided by PVR. Regardless, additional studies are now needed to provide prospective comparisons between both ratios.

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右心室流出道速度时间间隔：一个宝贵但被遗忘的超声心动图变量

背景超声心动图检查右心室流出道（RVOT）在检查肺动脉（PA）血流和右心室血流动力学对增加后负荷的反应方面是非常宝贵的。目前，TAPSE/PASP比率是首选的无创评估变量。方法我们的主要目的是确定RVOT VTI多普勒测量值与大范围不同左室射血分数和PASP值的TAPSE/PASP比值之间可能存在的具体关系。我们的研究首次根据目前流行的PA-RV血流动力学为RVOT VTI提供了临界值。当TAPSE值为2 cm时，正常RVOT VTI值应为13 cm。然而，当PASP或PVR用于度量分析时，如果PASP值为35 mmHg或PVR值为1.6 WU， RVOT VTI值为15 cm。最有趣的是，我们发现RVOT VTI与TAPSE/PASP比率之间没有相关性。相反，RVOT VTI/PVR比值非常有用，可以作为评估RV-PA耦合的潜在超声心动图替代方案。即使TAPSE和RVOT VTI，以及PASP和PVR都传达了一些相似的信息，但这些变量之间存在显著的解剖和功能差异。这些差异可能解释了为什么RVOT VTI/PVR比值可能比TAPSE/PASP更有用，特别是考虑到在某些临床情况下使用TAPSE的局限性和PVR提供的更可靠的血流动力学数据。无论如何，现在需要更多的研究来提供这两个比率之间的前瞻性比较。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echocardiography-A Journal of Cardiovascular Ultrasound and Allied Techniques 医学-心血管系统

CiteScore

2.40

自引率

6.70%

发文量

211

审稿时长

3-6 weeks

期刊介绍： Echocardiography: A Journal of Cardiovascular Ultrasound and Allied Techniques is the official publication of the International Society of Cardiovascular Ultrasound. Widely recognized for its comprehensive peer-reviewed articles, case studies, original research, and reviews by international authors. Echocardiography keeps its readership of echocardiographers, ultrasound specialists, and cardiologists well informed of the latest developments in the field.