Objective measures of right ventricular function during exercise: results of a pilot study

Area of Science:

• Cardiology
• Echocardiography
• Pulmonary Hypertension

Background:

• Reduced right ventricular (RV) systolic function is linked to pulmonary arterial hypertension (PAH) symptoms, morbidity, and adverse outcomes.
• Supine bicycle stress echocardiography (sBEE) is a feasible method for assessing RV resistance and compliance during exercise.

Purpose of the Study:

• To evaluate the reliability and accuracy of sBEE in assessing RV systolic function during exercise.
• To determine objective measures of RV performance and feasibility of sBEE.

Main Methods:

• Retrospective analysis of 30 sBEE studies for dyspnea or exercise intolerance.
• Calibration cohort (10 studies) to establish RV performance measures and feasibility.
• Validation cohort (20 studies) to confirm findings.

Main Results:

• Tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity are reliable RV measures during sBEE, even by untrained readers.
• RV myocardial performance (Tei index) and peak RV strain measurements are time-consuming, unreliable, and not recommended for RV function evaluation during sBEE.

Conclusions:

• sBEE shows promise for detecting RV abnormalities during exercise.
• Larger prospective studies are needed to confirm if TAPSE and tricuspid annular systolic velocity during sBEE can assess patients with exercise-induced dyspnea or suspected PAH.