Three-dimensional speckle tracking of the Three-dimensional speckle tracking of the right ventricle : right ventricle : Implications on survival in pulmonary hypertension Implications on survival in pulmonary hypertension Moceri P, Duchateau N, Baudouy D, Leroy S, Bouvier P, Moceri P Schouver D, Sermesant M, Ferrari E. Cardiology Department, CHU de Nice, FR Asclepios Research Project, INRIA, Sophia-Antipolis
Declaration of Interest Declaration of Interest • No conflict of interest • Funding sources: – University hospital of Nice, France (AO2I 2013; AOI 2014) – European Union 7th Framework Programme (VP2HF FP7-2013-611823) – European Research Council (MedYMA ERC-AdG-2011-291080)
Background / Objectives Background / Objectives • Survival in PH relates to RV function • 2D analysis of RV anatomy and structure is limited • Little is known about 3D RV global and regional function 3D RV deformation differences between healthy controls and PH adult patients ? Implications of global and regional 3D RV shape and deformation on clinical condition and survival in PH ?
• Non commercial software 3D Echo 3D Echo • TomTec 4D RV Post-processing of Temporal alignment End of study • Inclusion Regional and global motion Inclusion Function 2.0 3D RV meshes and deformation • 3D RV area strain Methods Methods Follow-up • Prospective cohort study • 104 PH patients • 34 healthy controls
Results Results • Highest deformation : lateral and inferior wall • RV shape and deformation related to NYHA class p<0.001 • Gradual RV dilatation – Spherical RV shape in advanced PH patients
Results (2) Results (2) • Median follow-up : 6.7 months [5.8-7.2] – 16 patients (15.4%) died from PH • RV Global area strain > - 18% – Independent predictor of survival – Identifies high-risk PH patients with a 48%-increased risk of death • ICC for inter-observer variability : 0.90
Conclusion Conclusion • RV shape and strain patterns are gradually deteriorated in PH – Independent prognostic marker in PH • 3D area strain helps understand the RV deformation – And could help stratifying the risk in PH patients Perspectives Perspectives • Development of RV-dedicated 3D speckle-tracking software • Generalization and validation of 3D RV study Thank you you Thank • Development of 3D regional assessment
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