Background: Exercise echocardiography is used for assessment of pulmonary circulation and right ventricular function, but limits of normal and disease-specific changes remain insufficiently established. Objectives: The objective of this study was to explore the physiological vs pathologic response of the right ventricle and pulmonary circulation to exercise. Methods: A total of 2,228 subjects were enrolled: 375 healthy controls, 40 athletes, 516 patients with cardiovascular risk factors, 17 with pulmonary arterial hypertension, 872 with connective tissue diseases without overt pulmonary hypertension, 113 with left-sided heart disease, 30 with lung disease, and 265 with chronic exposure to high altitude. All subjects underwent resting and exercise echocardiography on a semirecumbent cycle ergometer. All-cause mortality was recorded at follow-up. Results: The 5th and 95th percentile of the mean pulmonary artery pressure-cardiac output relationships were 0.2 to 3.5 mm Hg.min/L in healthy subjects without cardiovascular risk factors, and were increased in all patient categories and in high altitude residents. The 5th and 95th percentile of the tricuspid annular plane systolic excursion to systolic pulmonary artery pressure ratio at rest were 0.7 to 2.0 mm/mm Hg at rest and 0.5 to 1.5 mm/mm Hg at peak exercise, and were decreased at rest and exercise in all disease categories and in high-altitude residents. An increased all-cause mortality was predicted by a resting tricuspid annular plane systolic excursion to systolic pulmonary artery pressure <0.7 mm/mm Hg and mean pulmonary artery pressure-cardiac output >5 mm Hg.min/L. Conclusions: Exercise echocardiography of the pulmonary circulation and the right ventricle discloses prognostically relevant differences between healthy subjects, athletes, high-altitude residents, and patients with various cardio-respiratory conditions. (Right Heart International NETwork During Exercise in Different Clinical Conditions; NCT03041337).
Exercise Stress Echocardiography of the Right Ventricle and Pulmonary Circulation / RIGHT Heart International NETwork (RIGHT-NET) Investigators: Eduardo Bossone, Luna Gargani, Robert Naeije, Francesco Ferrara, William F Armstrong, Theodore John Kolias, Valentina Capone, Rosangela Cocchia, Ciro Mauro, Chiara Sepe, Filippo Cademartiri, Iacopo Fabiani, Francesco Capuano, Rodolfo Citro, Rossella Benvenga, Michele Bellino, Giuseppe Iuliano, Serena Migliarino, Ilaria Radano, Antonio Cittadini, Michele Arcopinto, Alberto Marra, Giulia Crisci, Roberta D'Assante, Mariarosaria De Luca, Federica Giardino, Carmen Rainone, Salvatore Rega, Valeria Valente, Michele D'Alto, Paola Argiento, Antonello D'Andrea, Francesco Ferrara, Valentina Russo, Luna Gargani, Paolo Frumento, Matteo Mazzola, Santo Dellegrottaglie, Giovanni Di Salvo, Stefano Ghio, Stefania Guida, Ekkerard Grunig, Christina A Eichstaedt, Marco Guazzi, Francesco Bandera, Valentina Labate, André La Gerch, Giuseppe Limongelli, Andreina Carbone, Giuseppe Pacileo, Marina Verrengia, Jaroslaw D Kasprzak, Karina Wierzbowska-Drabik, Gabor Kovacs, Philipp Douschan, Antonella Moreo, Francesca Casadei, Benedetta De Chiara, Robert Naeije, Ellen Ostenfeld, Gianni Pedrizzetti, Marco Matucci-Cerinic, Francesco Pieri, Fabio Mori, Alberto Moggi-Pignone, Lorenza Pratali, Mauro Raciti, Nicola Pugliese, Nicolò De Biase, Gennaro D'Angelo, Brigida Ranieri, Rossana Castaldo, Monica Franzese, Andrea Salzano, Lawrence Rudski, Rajan Saggar, Walter Serra, Anna Agnese Stanziola, D'Angelo Rossella, Lorena Gallotta, István Szabó, Albert Varga, Gergely Agoston, Damien Voilliot, Olga Vriz, Domenico Galzerano, Mani Vannan, Sara Mobasseri, Peter Flueckiger, Shizhen Liu. - In: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. - ISSN 0735-1097. - ELETTRONICO. - 82:(2023), pp. 1973-1985. [10.1016/j.jacc.2023.09.807]
Exercise Stress Echocardiography of the Right Ventricle and Pulmonary Circulation
Luna Gargani
Membro del Collaboration Group
;Francesco Capuano;Alberto Marra;Valentina Russo;Luna Gargani;Paolo Frumento;Antonella Moreo;Gianni Pedrizzetti;Marco Matucci-Cerinic;Francesco Pieri;Fabio Mori;Alberto Moggi-Pignone
;
2023
Abstract
Background: Exercise echocardiography is used for assessment of pulmonary circulation and right ventricular function, but limits of normal and disease-specific changes remain insufficiently established. Objectives: The objective of this study was to explore the physiological vs pathologic response of the right ventricle and pulmonary circulation to exercise. Methods: A total of 2,228 subjects were enrolled: 375 healthy controls, 40 athletes, 516 patients with cardiovascular risk factors, 17 with pulmonary arterial hypertension, 872 with connective tissue diseases without overt pulmonary hypertension, 113 with left-sided heart disease, 30 with lung disease, and 265 with chronic exposure to high altitude. All subjects underwent resting and exercise echocardiography on a semirecumbent cycle ergometer. All-cause mortality was recorded at follow-up. Results: The 5th and 95th percentile of the mean pulmonary artery pressure-cardiac output relationships were 0.2 to 3.5 mm Hg.min/L in healthy subjects without cardiovascular risk factors, and were increased in all patient categories and in high altitude residents. The 5th and 95th percentile of the tricuspid annular plane systolic excursion to systolic pulmonary artery pressure ratio at rest were 0.7 to 2.0 mm/mm Hg at rest and 0.5 to 1.5 mm/mm Hg at peak exercise, and were decreased at rest and exercise in all disease categories and in high-altitude residents. An increased all-cause mortality was predicted by a resting tricuspid annular plane systolic excursion to systolic pulmonary artery pressure <0.7 mm/mm Hg and mean pulmonary artery pressure-cardiac output >5 mm Hg.min/L. Conclusions: Exercise echocardiography of the pulmonary circulation and the right ventricle discloses prognostically relevant differences between healthy subjects, athletes, high-altitude residents, and patients with various cardio-respiratory conditions. (Right Heart International NETwork During Exercise in Different Clinical Conditions; NCT03041337).
I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
