Right Ventricular and Pulmonary Vascular Function are Influenced by Age and Volume Expansion in Healthy Humans
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Right Ventricular and Pulmonary Vascular Function are Influenced by Age and Volume Expansion in Healthy Humans. / Wolsk, Emil; Bakkestrøm, Rine; Kristensen, Charlotte Burup; Aagaard Myhr, Katrine; Thomsen, Jakob H; Balling, Louise; Andersen, Mads J; Dahl, Jordi S; Shah, Sanjiv J; Gustafsson, Finn; Hassager, Christian; Møller, Jacob E.
I: Journal of Cardiac Failure, Bind 25, Nr. 1, 01.2019, s. 51-59.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Right Ventricular and Pulmonary Vascular Function are Influenced by Age and Volume Expansion in Healthy Humans
AU - Wolsk, Emil
AU - Bakkestrøm, Rine
AU - Kristensen, Charlotte Burup
AU - Aagaard Myhr, Katrine
AU - Thomsen, Jakob H
AU - Balling, Louise
AU - Andersen, Mads J
AU - Dahl, Jordi S
AU - Shah, Sanjiv J
AU - Gustafsson, Finn
AU - Hassager, Christian
AU - Møller, Jacob E
N1 - Copyright © 2018. Published by Elsevier Inc.
PY - 2019/1
Y1 - 2019/1
N2 - BACKGROUND: Patients with heart failure (HF) often show signs of right ventricular (RV) dysfunction. The RV function of coupled with the pulmonary circulation (tricuspid annular plane systolic excursion [TAPSE]/pulmonary arterial systolic pressure [PASP]) has been shown to divide HF patients into distinct prognostic strata, but less is known about which factors influence this prognostic marker, and whether those factors can be modified. We sought to obtain normative values and discern the individual effects of age, sex, and fluid overload on RV function.METHODS AND RESULTS: Sixty healthy subjects aged 20-80 years were enrolled in this prospective study. Right heart catheterization with hemodynamic measurements were performed at rest after a rapid saline solution infusion (10 mL/kg, 150 mL/min). Linear regression and Spearman correlation models were used to estimate associations between TAPSE/PASP and relevant variables. In healthy persons of all ages, the median (5th-95th percentiles) normative TASPE-PASP ratio was 1.25 (0.81-1.78) mm/mm Hg. The correlation between progressive age and declining TAPSE/PASP was significant (r = -0.35; P = .006). Sex did not influence TAPSE/PASP (P = .30). Rapid fluid expansion increased central venous pressure from 5 ± 2 mm Hg to 11 ± 4 mm Hg after fluid infusion (P < .0001). This resulted in a 32% decrease in the TAPSE-PASP ratio after fluid infusion, compared to baseline (P < .0001).CONCLUSIONS: The TAPSE-PASP ratio was affected by age, but not sex. TAPSE/PASP is not only a reflection of intrinsic RV function and pulmonary vascular coupling, but fluid status also dynamically affects this index of RV function. Normative values with invasive measurements were obtained for future assessment of HF patients.
AB - BACKGROUND: Patients with heart failure (HF) often show signs of right ventricular (RV) dysfunction. The RV function of coupled with the pulmonary circulation (tricuspid annular plane systolic excursion [TAPSE]/pulmonary arterial systolic pressure [PASP]) has been shown to divide HF patients into distinct prognostic strata, but less is known about which factors influence this prognostic marker, and whether those factors can be modified. We sought to obtain normative values and discern the individual effects of age, sex, and fluid overload on RV function.METHODS AND RESULTS: Sixty healthy subjects aged 20-80 years were enrolled in this prospective study. Right heart catheterization with hemodynamic measurements were performed at rest after a rapid saline solution infusion (10 mL/kg, 150 mL/min). Linear regression and Spearman correlation models were used to estimate associations between TAPSE/PASP and relevant variables. In healthy persons of all ages, the median (5th-95th percentiles) normative TASPE-PASP ratio was 1.25 (0.81-1.78) mm/mm Hg. The correlation between progressive age and declining TAPSE/PASP was significant (r = -0.35; P = .006). Sex did not influence TAPSE/PASP (P = .30). Rapid fluid expansion increased central venous pressure from 5 ± 2 mm Hg to 11 ± 4 mm Hg after fluid infusion (P < .0001). This resulted in a 32% decrease in the TAPSE-PASP ratio after fluid infusion, compared to baseline (P < .0001).CONCLUSIONS: The TAPSE-PASP ratio was affected by age, but not sex. TAPSE/PASP is not only a reflection of intrinsic RV function and pulmonary vascular coupling, but fluid status also dynamically affects this index of RV function. Normative values with invasive measurements were obtained for future assessment of HF patients.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Aging/pathology
KW - Blood Pressure/physiology
KW - Blood Volume/physiology
KW - Cardiac Catheterization/trends
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Prospective Studies
KW - Pulmonary Artery/diagnostic imaging
KW - Stroke Volume/physiology
KW - Ventricular Function, Right/physiology
KW - Young Adult
U2 - 10.1016/j.cardfail.2018.11.013
DO - 10.1016/j.cardfail.2018.11.013
M3 - Journal article
C2 - 30472282
VL - 25
SP - 51
EP - 59
JO - Journal of Cardiac Failure
JF - Journal of Cardiac Failure
SN - 1071-9164
IS - 1
ER -
ID: 235152561