TITLE:
Efficacy of Isovolumic Acceleration in Assessing Right Ventricular Function in Pulmonary Hypertension
AUTHORS:
V. S. Bharathi, Adikesava Naidu Otikunta, Y. V. Subbareddy, K. Laxman Rao, Syed Imamuddin, Ashok Thakkar
KEYWORDS:
Pulmonary Hypertension, Isovolumic Acceleration, Right Ventricular Dysfunction
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.5 No.12,
June
20,
2014
ABSTRACT: Objective: The aim of the study was to determine
usefulness of isovolumic acceleration to assess right ventricular function in
patients with pulmonary hypertension. Background: Right ventricular
dysfunction is a powerful predictor of adverse outcomes in patients with
pulmonary hypertension. Although isovolumic acceleration is a sensitive and relatively
load-independent parameter for ventricular contractile function, it has not
been widely used. So, the aim of the study was to determine the usefulness of
isovolumic acceleration in assessing right ventricular function in patients
with pulmonary hypertension. Methods: A single center, prospective
observational case-control study has been carried out for the period of one
year at Osmania general hospital (Hyderabad). A total of 32 consecutive
patients with pulmonary hypertension and 32 age matched healthy controls were
recruited in the study as per the inclusion and exclusion criteria of the
study. Receiver operator characteristic curves were
used to study sensitivity, specificity, positive predictive value, negative predictive values as well as pearson’s
correlation coefficients. Results: The
results of the study showed that isovolumic acceleration has
good significant correlation with right ventricular fractional area change (r
= 0.554, p = 0.001) and tissue Doppler myocardial performance index (r = -0.599,
p = 0.001) whereas a lesser but significant correlation was observed with tricuspid
annular plane systolic excursion (r = 0.327, p = 0.034). Isovolumic
acceleration showed higher specificity (81%) and positive predictive value (88%)
in diagnosing right ventricular dysfunction in pulmonary hypertension
compared to tricuspid annular systolic excursion velocity and tissue Doppler myocardial performance index parameters. Therefore isovolumic acceleration may be a better variable for
diagnosing right ventricular dysfunction.
Conclusions: Isovolumic acceleration
is a sensitive and specific marker of right ventricular function in pulmonary
hypertension.