01 March 2017 by Bahri Akdeniz

A simple and valuable echocardiographic parameter for predicting prognosis in pulmonary hypertension; RVOT maximal systolic velocity

Introduction

Right ventricular outflow tract maximal systolic velocity (RVOT Vmax) at echocardiography  may reflect pulmonary flow and cardiac output, which are important predictors in pulmonary hypertension (PH). In this study we aimed to asses the prognostic value of this simple echocardiographic parameter in predicting long term outcome in patients with PH.

Materials and methods

We assigned 116 consecutive patients, under the regular follow up at PH centre in Dokuz Eylul  University Hospital. In this cohort, echocardiographic parameters at initial diagnosis were recorded including RVOT Vmax in addition to TAPSE, right ventricular annular tissue Doppler systolic velocity (RV S), RV Tei index, right atrial area (RAA), RV fractional area change (RFAC), and systolic pulmonary artery pressure (sPAP). Patients were followed up periodically with 3 months intervals. The prognostic value of these parameters were analyzed by Cox regression model.

Results

In a mean follow-up of 36 months, 42 deaths occurred. In univariate analyses, TAPSE and RVOT Vmax were found to be significantly associated with death. In multivariate analysis, RVOT Vmax was the only independent echocardiographic predictor of death (Table 1). Cut-off value of RVOT Vmax for death, which calculated by ROC analyses was 0.82 cm/sec. The hazard ratio for RVOT Vmax values < 82.1 for death was 2.479 (%95 CI: 1.261- 4.874; p=0.008).

Conclusion

This study indicated the importance of RVOT Vmax for predicting survival in patients with PH. Thissimple, easily measured echocardiographic parameter may be considered as an important surrogate marker in our clinical practice in PH patients.

Key Contributors

Bahri Akdeniz, Ebru Özpelit, Kemal Can Tertermiz, Dilek Sezgin, Nezihi Barış, Melih Birlik, Can Sevinç


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