Novel Echocardiographic Parameter Assessing Pulmonary Vascular Resistance in Patient with Acyanotic Congenital Heart Disease

Background Pulmonary vascular resistance (PVR) is an important variable in management of acyanotic congenital heart disease. Right heart catheterization (RHC) using impedance catheter remains gold standard for pulmonary vascular resistance (PVR) measurement. The ratio of peak tricuspid regurgita...

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Main Authors: Muhammad Raihan Ramadhan Natadikarta, Charlotte Johanna Cool, Achmad Fitrah Khalid, Norman Sukmadi, Januar Wibawa Martha
Format: Article
Language:English
Published: Indonesian Heart Association 2025-01-01
Series:Majalah Kardiologi Indonesia
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Online Access:https://ijconline.id/index.php/ijc/article/view/1790
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author Muhammad Raihan Ramadhan Natadikarta
Charlotte Johanna Cool
Achmad Fitrah Khalid
Norman Sukmadi
Januar Wibawa Martha
author_facet Muhammad Raihan Ramadhan Natadikarta
Charlotte Johanna Cool
Achmad Fitrah Khalid
Norman Sukmadi
Januar Wibawa Martha
author_sort Muhammad Raihan Ramadhan Natadikarta
collection DOAJ
description Background Pulmonary vascular resistance (PVR) is an important variable in management of acyanotic congenital heart disease. Right heart catheterization (RHC) using impedance catheter remains gold standard for pulmonary vascular resistance (PVR) measurement. The ratio of peak tricuspid regurgitant velocity to the right ventricular outflow tract time-velocity integral (TRVmax/RVOTVTI) was presented as a reliable non-invasive method of estimating PVR. Recently, right ventricular 2-dimensional speckle tracking strain (RVGLS) was proven as a new promising parameter to evaluate PVR. This study performed to examine whether this new non-invasive variable ratio (TRVmax/RVGLS) provides clinically reliable method to determine pulmonary vascular resistance (PVR) obtained by echocardiography. Methods Right-heart catheterization and echocardiographic examination were performed in 56 patients with congenital heart disease. The ratio of TRVmax/RVOTVTI and TRVmax/RVGLS analysis performed using receiver-operating characteristic curve analysis, a cutoff value for the ratio was generated to determine PVR more than 5 WU. Results A TRVmax/RVOTVTI cutoff value of 0.21 provided a sensitivity of 77.1% and a specificity of 81% (CI 81% to 97.5%) and TRVmax/RVGLS cutoff value of -23.16 provided sensitivity of 74.3% and a specificity of 90.5% to determine PVR > 5 WU (CI 79.6% to 98.2%).   Conclusions The echocardiography parameter (TRVmax/RVGLS) could serve as a dependable noninvasive method to predict PVR greater than 5 WU in acyanotic congenital heart disease patients.
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spelling doaj-art-b033fbdb07b44c7084922f54f44f5cf52025-01-10T16:38:11ZengIndonesian Heart AssociationMajalah Kardiologi Indonesia0126-37732620-47622025-01-0146110.30701/ijc.1790Novel Echocardiographic Parameter Assessing Pulmonary Vascular Resistance in Patient with Acyanotic Congenital Heart DiseaseMuhammad Raihan Ramadhan Natadikarta0Charlotte Johanna Cool1Achmad Fitrah Khalid2Norman Sukmadi3Januar Wibawa Martha4Departement of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, IndonesiaDepartement of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, IndonesiaDepartement of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, IndonesiaDepartement of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, IndonesiaDepartement of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia Background Pulmonary vascular resistance (PVR) is an important variable in management of acyanotic congenital heart disease. Right heart catheterization (RHC) using impedance catheter remains gold standard for pulmonary vascular resistance (PVR) measurement. The ratio of peak tricuspid regurgitant velocity to the right ventricular outflow tract time-velocity integral (TRVmax/RVOTVTI) was presented as a reliable non-invasive method of estimating PVR. Recently, right ventricular 2-dimensional speckle tracking strain (RVGLS) was proven as a new promising parameter to evaluate PVR. This study performed to examine whether this new non-invasive variable ratio (TRVmax/RVGLS) provides clinically reliable method to determine pulmonary vascular resistance (PVR) obtained by echocardiography. Methods Right-heart catheterization and echocardiographic examination were performed in 56 patients with congenital heart disease. The ratio of TRVmax/RVOTVTI and TRVmax/RVGLS analysis performed using receiver-operating characteristic curve analysis, a cutoff value for the ratio was generated to determine PVR more than 5 WU. Results A TRVmax/RVOTVTI cutoff value of 0.21 provided a sensitivity of 77.1% and a specificity of 81% (CI 81% to 97.5%) and TRVmax/RVGLS cutoff value of -23.16 provided sensitivity of 74.3% and a specificity of 90.5% to determine PVR > 5 WU (CI 79.6% to 98.2%).   Conclusions The echocardiography parameter (TRVmax/RVGLS) could serve as a dependable noninvasive method to predict PVR greater than 5 WU in acyanotic congenital heart disease patients. https://ijconline.id/index.php/ijc/article/view/1790Congenital Heart DiseaseEchocardiographyPulmonary HypertensionPulmonary Vascular ResistanceRight Ventricle Global Longitudinal Strain
spellingShingle Muhammad Raihan Ramadhan Natadikarta
Charlotte Johanna Cool
Achmad Fitrah Khalid
Norman Sukmadi
Januar Wibawa Martha
Novel Echocardiographic Parameter Assessing Pulmonary Vascular Resistance in Patient with Acyanotic Congenital Heart Disease
Majalah Kardiologi Indonesia
Congenital Heart Disease
Echocardiography
Pulmonary Hypertension
Pulmonary Vascular Resistance
Right Ventricle Global Longitudinal Strain
title Novel Echocardiographic Parameter Assessing Pulmonary Vascular Resistance in Patient with Acyanotic Congenital Heart Disease
title_full Novel Echocardiographic Parameter Assessing Pulmonary Vascular Resistance in Patient with Acyanotic Congenital Heart Disease
title_fullStr Novel Echocardiographic Parameter Assessing Pulmonary Vascular Resistance in Patient with Acyanotic Congenital Heart Disease
title_full_unstemmed Novel Echocardiographic Parameter Assessing Pulmonary Vascular Resistance in Patient with Acyanotic Congenital Heart Disease
title_short Novel Echocardiographic Parameter Assessing Pulmonary Vascular Resistance in Patient with Acyanotic Congenital Heart Disease
title_sort novel echocardiographic parameter assessing pulmonary vascular resistance in patient with acyanotic congenital heart disease
topic Congenital Heart Disease
Echocardiography
Pulmonary Hypertension
Pulmonary Vascular Resistance
Right Ventricle Global Longitudinal Strain
url https://ijconline.id/index.php/ijc/article/view/1790
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