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Age-changes in right ventricular function-pulmonary circulation coupling: from pediatric to adult stage in 1899

Olga Vriz1,2, Gruschen Veldman3, Luna Gargani4

  • 1Cardiac Centre, King Faisal Specialist Hospital and Research Center, Zahrawi St, Al Maather, Al Maazer, Riyadh, 12713, Saudi Arabia. olgavriz@yahoo.com.

The International Journal of Cardiovascular Imaging
|July 6, 2021
PubMed

Insights

Right ventricular function and coupling change with age, with systolic pulmonary artery pressure increasing and tricuspid annular plane systolic excursion decreasing. However, the relationship between these measures remains stable across age groups.

Area of Science:

  • Cardiology
  • Echocardiography
  • Physiology

Background:

  • Right ventricular (RV) function and its coupling with the pulmonary artery (PA) are crucial for cardiovascular health.
  • Age-related changes in RV function and RV-PA coupling are not fully understood, necessitating reference values for healthy individuals.
  • Understanding these changes is vital for diagnosing and managing various cardiopulmonary conditions.

Purpose of the Study:

  • To analyze age-specific changes in RV function and RV-PA coupling in a large cohort of healthy individuals.
  • To establish reference values for tricuspid annular plane systolic excursion (TAPSE), systolic pulmonary artery pressure (SPAP), and the TAPSE/SPAP ratio across a wide age range.
  • To investigate the influence of clinical and echocardiographic factors on these parameters.

Main Methods:

  • A standardized transthoracic echocardiographic examination was performed on 1899 consecutive healthy subjects.
  • Tricuspid annular plane systolic excursion (TAPSE) and systolic pulmonary artery pressure (SPAP) were measured.
  • Quantile regression analysis was used to determine reference values and associations with age and other cofactors.

Main Results:

  • Systolic pulmonary artery pressure (SPAP) increased with age, while TAPSE and the TAPSE/SPAP ratio decreased.
  • Multivariate analysis revealed significant associations of TAPSE with body surface area (BSA), stroke volume (SV), and E/A, and inverse associations with heart rate and E/e'.
  • SPAP was positively associated with age, SV, E/A, and E/e', and negatively with BSA. The TAPSE/SPAP ratio showed negative associations with age, female sex, and E/e', and a positive association with BSA.

Conclusions:

  • TAPSE, SPAP, and their ratio exhibit significant age-related trends and associations with diastolic function, sex, and BSA.
  • Despite age-related changes, the ventriculo-arterial coupling (TAPSE/SPAP ratio) is relatively well-preserved across the age spectrum.
  • The study provides valuable reference values for RV function and RV-PA coupling in healthy individuals, aiding in clinical interpretation.

Keywords:
EchocardiographyNormal subjectsPulmonary artery systolic pressureRight ventricular–arterial couplingTricuspid annular plane systolic excursion

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