Paolo Manca, Vincenzo Nuzzi, Alessandro Lucchino, Gerardo Rugiano, Massimiliano Mulè, Alessandra Carvelli, Stefano Cannata, Sergio Sciacca, Francesca Parisi, Sabato Sorrentino, Francesco Fulvio Faletra, Paolo C. Colombo, Manlio Gianni Cipriani
{"title":"右心室整体工作效率：一个可靠的无创估计右心室收缩。","authors":"Paolo Manca, Vincenzo Nuzzi, Alessandro Lucchino, Gerardo Rugiano, Massimiliano Mulè, Alessandra Carvelli, Stefano Cannata, Sergio Sciacca, Francesca Parisi, Sabato Sorrentino, Francesco Fulvio Faletra, Paolo C. Colombo, Manlio Gianni Cipriani","doi":"10.1002/ehf2.15354","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Right ventricular (RV) myocardial work (RVMW) recently emerged as a non-invasive alternative for the assessment of RV contractility. However, none of the prior studies assessed its variations under different haemodynamic conditions. We aimed to evaluate the variations of the components of RVMW in heart failure (HF) patients with pulmonary hypertension (PH) undergoing a reversibility test.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Consecutive HF patients with reduced ejection fraction who underwent right heart catheterization and echocardiography at our institution were prospectively enrolled. Patients with PH and augmented pulmonary vascular resistance who achieved normalization of pulmonary pressures after the reversibility test using vasodilators underwent a second echocardiographic assessment under the same haemodynamic conditions. Four components of RVMW were analysed: (1) RV global work index (mmHg%); (2) RV global constructive work (mmHg%); (3) RV global wasted work (RVGWW) (mmHg%); (4) RV global work efficiency (RVGWE) (%).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>One hundred two patients were enrolled (53 with PH and 49 without). Global RVMW was higher in patients with PH, due to a significantly higher RVGWW [81 (55–119) mmHg% vs. 49 (28–72) mmHg%; <i>P</i> = 0.013], while RVGWE was similar between the two groups (80 ± 10% vs. 82 ± 12%; P = 0.332). In patients with PH, 27/52 (51.9%) had combined PH, while 25/52 (48.1%) had isolated post-capillary PH. A reversibility test was performed in 26/27 (96.2%) patients with combined PH and pulmonary pressure normalization was observed in 16/26 (61.5%) subjects. In patients with PH normalization, RVGWE remained almost unchanged (from 82.8 ± 6.9% to 85.3 ± 6.6%; <i>P</i> = 0.596), while RVGWW significantly decreased [from 60 (49–90) mmHg% to 41 (31–53) mmHg%; <i>P</i> = 0.027]. Among all the echocardiographic and haemodynamic parameters adopted for assessing RV function, RVGWE was the least variable during the reversibility test (mean variation 3 ± 10%).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>RVGWE is comparable between HF patients with and without PH and remains stable across different haemodynamic conditions. This consistency suggests that it can be a reliable parameter for assessing RV contractility. Larger studies are needed to confirm this hypothesis and to test its prognostic significance.</p>\n </section>\n </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 5","pages":"3719-3730"},"PeriodicalIF":3.7000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15354","citationCount":"0","resultStr":"{\"title\":\"Right ventricular global work efficiency: A reliable non-invasive estimate of right ventricular contractility\",\"authors\":\"Paolo Manca, Vincenzo Nuzzi, Alessandro Lucchino, Gerardo Rugiano, Massimiliano Mulè, Alessandra Carvelli, Stefano Cannata, Sergio Sciacca, Francesca Parisi, Sabato Sorrentino, Francesco Fulvio Faletra, Paolo C. Colombo, Manlio Gianni Cipriani\",\"doi\":\"10.1002/ehf2.15354\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>Right ventricular (RV) myocardial work (RVMW) recently emerged as a non-invasive alternative for the assessment of RV contractility. However, none of the prior studies assessed its variations under different haemodynamic conditions. We aimed to evaluate the variations of the components of RVMW in heart failure (HF) patients with pulmonary hypertension (PH) undergoing a reversibility test.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Consecutive HF patients with reduced ejection fraction who underwent right heart catheterization and echocardiography at our institution were prospectively enrolled. Patients with PH and augmented pulmonary vascular resistance who achieved normalization of pulmonary pressures after the reversibility test using vasodilators underwent a second echocardiographic assessment under the same haemodynamic conditions. Four components of RVMW were analysed: (1) RV global work index (mmHg%); (2) RV global constructive work (mmHg%); (3) RV global wasted work (RVGWW) (mmHg%); (4) RV global work efficiency (RVGWE) (%).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>One hundred two patients were enrolled (53 with PH and 49 without). Global RVMW was higher in patients with PH, due to a significantly higher RVGWW [81 (55–119) mmHg% vs. 49 (28–72) mmHg%; <i>P</i> = 0.013], while RVGWE was similar between the two groups (80 ± 10% vs. 82 ± 12%; P = 0.332). In patients with PH, 27/52 (51.9%) had combined PH, while 25/52 (48.1%) had isolated post-capillary PH. A reversibility test was performed in 26/27 (96.2%) patients with combined PH and pulmonary pressure normalization was observed in 16/26 (61.5%) subjects. In patients with PH normalization, RVGWE remained almost unchanged (from 82.8 ± 6.9% to 85.3 ± 6.6%; <i>P</i> = 0.596), while RVGWW significantly decreased [from 60 (49–90) mmHg% to 41 (31–53) mmHg%; <i>P</i> = 0.027]. Among all the echocardiographic and haemodynamic parameters adopted for assessing RV function, RVGWE was the least variable during the reversibility test (mean variation 3 ± 10%).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>RVGWE is comparable between HF patients with and without PH and remains stable across different haemodynamic conditions. This consistency suggests that it can be a reliable parameter for assessing RV contractility. Larger studies are needed to confirm this hypothesis and to test its prognostic significance.</p>\\n </section>\\n </div>\",\"PeriodicalId\":11864,\"journal\":{\"name\":\"ESC Heart Failure\",\"volume\":\"12 5\",\"pages\":\"3719-3730\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15354\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ESC Heart Failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ehf2.15354\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ESC Heart Failure","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ehf2.15354","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Right ventricular global work efficiency: A reliable non-invasive estimate of right ventricular contractility
Background
Right ventricular (RV) myocardial work (RVMW) recently emerged as a non-invasive alternative for the assessment of RV contractility. However, none of the prior studies assessed its variations under different haemodynamic conditions. We aimed to evaluate the variations of the components of RVMW in heart failure (HF) patients with pulmonary hypertension (PH) undergoing a reversibility test.
Methods
Consecutive HF patients with reduced ejection fraction who underwent right heart catheterization and echocardiography at our institution were prospectively enrolled. Patients with PH and augmented pulmonary vascular resistance who achieved normalization of pulmonary pressures after the reversibility test using vasodilators underwent a second echocardiographic assessment under the same haemodynamic conditions. Four components of RVMW were analysed: (1) RV global work index (mmHg%); (2) RV global constructive work (mmHg%); (3) RV global wasted work (RVGWW) (mmHg%); (4) RV global work efficiency (RVGWE) (%).
Results
One hundred two patients were enrolled (53 with PH and 49 without). Global RVMW was higher in patients with PH, due to a significantly higher RVGWW [81 (55–119) mmHg% vs. 49 (28–72) mmHg%; P = 0.013], while RVGWE was similar between the two groups (80 ± 10% vs. 82 ± 12%; P = 0.332). In patients with PH, 27/52 (51.9%) had combined PH, while 25/52 (48.1%) had isolated post-capillary PH. A reversibility test was performed in 26/27 (96.2%) patients with combined PH and pulmonary pressure normalization was observed in 16/26 (61.5%) subjects. In patients with PH normalization, RVGWE remained almost unchanged (from 82.8 ± 6.9% to 85.3 ± 6.6%; P = 0.596), while RVGWW significantly decreased [from 60 (49–90) mmHg% to 41 (31–53) mmHg%; P = 0.027]. Among all the echocardiographic and haemodynamic parameters adopted for assessing RV function, RVGWE was the least variable during the reversibility test (mean variation 3 ± 10%).
Conclusions
RVGWE is comparable between HF patients with and without PH and remains stable across different haemodynamic conditions. This consistency suggests that it can be a reliable parameter for assessing RV contractility. Larger studies are needed to confirm this hypothesis and to test its prognostic significance.
期刊介绍：
ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
