Three-dimensional right ventricular free-wall strain for identifying a higher Doppler-estimated PASP subgroup in high-altitude heart disease - Report - MDSpire
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Three-dimensional right ventricular free-wall strain for identifying a higher Doppler-estimated PASP subgroup in high-altitude heart disease
Clinical Report: Utilizing 3D Right Ventricular Free-Wall Strain in HAHD
Overview
This study evaluates the effectiveness of three-dimensional right ventricular free-wall longitudinal strain (absolute RVFWLS) in identifying patients with high-altitude heart disease (HAHD) who have elevated pulmonary artery systolic pressure (PASP).
Background
High-altitude heart disease (HAHD) is a significant health concern for individuals living at high altitudes, characterized by pulmonary hypertension and right ventricular dysfunction. Accurate assessment of right ventricular function is crucial for managing HAHD.
Data Highlights
Measure
Area Under ROC Curve
Absolute RVFWLS
0.886
TAPSE
0.647
Key Findings
Absolute RVFWLS demonstrated better discrimination for higher-PASP subgroup than TAPSE (ROC AUC: 0.886 vs. 0.647, P = 0.002).
Inclusion of absolute RVFWLS improved model fit beyond TAPSE, age, and sex (likelihood-ratio P < 0.001).
The odds ratio for each 1-percentage-point decrement in absolute RVFWLS was 1.81 (95% CI: 1.29–2.54).
RV-ESV accounted for 45.0% of the PASP–3D-EF association but did not significantly account for the PASP–absolute RVFWLS association.
Septal longitudinal strain was also reduced in patients with HAHD.
Clinical Implications
The findings suggest that three-dimensional absolute RVFWLS may be a more reliable echocardiographic measure for identifying elevated PASP in HAHD patients compared to TAPSE. Clinicians should consider incorporating this advanced imaging technique into their assessment protocols for better risk stratification.
Conclusion
Three-dimensional absolute RVFWLS offers superior discrimination for identifying higher-PASP subgroups in HAHD compared to traditional methods.
