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Updated: Nov 6, 2025

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography
07:11

Morphological and Functional Assessment of the Right Ventricle Using 3D Echocardiography

Published on: October 28, 2020

3.1K

Prognostic significance of right ventricular function during exercise in asymptomatic/minimally symptomatic patients

Kensuke Hirasawa1, Masaki Izumo2, Kei Mizukoshi2

  • 1Department of Cardiovascular Medicine, Tokyo Medical and Dental University, Tokyo, Japan.

Echocardiography (Mount Kisco, N.Y.)
|May 10, 2021
PubMed

Insights

Right ventricular function during exercise, measured by Ex-TAPSE and its ratio with pulmonary artery pressure, helps stratify risk in nonobstructive hypertrophic cardiomyopathy (nHCM) patients. Impaired RV function indicates a higher risk of adverse cardiac events.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Imaging

Background:

  • Risk stratification in hypertrophic cardiomyopathy (HCM) without left ventricular outflow tract (LVOT) obstruction is challenging.
  • The role of exercise stress echocardiography (ESE) in assessing these patients remains unclear.
  • Investigating right ventricular (RV) function and RV-pulmonary artery (PA) coupling during exercise is crucial for asymptomatic/minimally symptomatic patients with nonobstructive HCM (nHCM).

Purpose of the Study:

  • To evaluate the utility of RV function and RV-PA coupling during exercise in risk stratification of nHCM patients.
  • To determine if exercise parameters can predict adverse cardiac events in nHCM.

Main Methods:

  • Retrospective study of 74 nHCM patients undergoing ESE.
  • Analysis of tricuspid annular plane systolic excursion (Ex-TAPSE) and Ex-TAPSE/systolic pulmonary artery pressure (SPAP) ratio during exercise.
  • Cox regression and Kaplan-Meier analyses to assess association with cardiac events.

Main Results:

  • Eight patients (11%) experienced HCM-related cardiac events during follow-up.
  • Impaired Ex-TAPSE and Ex-TAPSE/SPAP ratio during exercise were significantly associated with adverse events.
  • Low Ex-TAPSE (<24 mm) and Ex-TAPSE/SPAP ratio (<0.50 mm/mmHg) predicted higher incidence of adverse outcomes.

Conclusions:

  • Reduced right ventricular function and RV-PA uncoupling during exercise are linked to adverse outcomes in nHCM.
  • Exercise-based RV assessment, specifically Ex-TAPSE and its ratio, is valuable for risk stratification in nHCM.
  • These findings highlight the importance of evaluating RV performance during stress in managing nHCM.
Abstract

Keywords:
exercise stress echocardiographyhypertrophic cardiomyopathyright ventricular function

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