Apply pressure-strain loop to quantify myocardial work in pulmonary hypertension: A prospective cohort study

Area of Science:

• Cardiology
• Cardiovascular Physiology
• Echocardiography

Background:

• Pulmonary hypertension (PH) is a severe condition affecting cardiac function.
• Quantifying myocardial work is crucial for understanding PH pathophysiology.
• Pressure-strain loop (PSL) analysis offers a novel method for assessing myocardial work.

Purpose of the Study:

• To evaluate the utility of myocardial work parameters derived from PSL in assessing cardiac function in PH patients.
• To determine the prognostic value of these parameters for clinical outcomes in PH.

Main Methods:

• A prospective study involving 52 PH patients and 27 healthy controls.
• Echocardiography-derived PSLs were used to calculate left ventricle (LV) and right ventricle (RV) global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE).
• Statistical analyses, including logistic regression and ROC curve analysis, were performed to assess correlations and predictive values.

Main Results:

• Patients with PH exhibited significantly higher LVGWW, RVGWI, RVGCW, and RVGWW compared to controls.
• LVGWE, LVGWI, LVGCW, and RVGWE were significantly lower in PH patients.
• Myocardial work parameters showed good correlation with clinical and conventional echocardiographic assessments.
• A combination of RVGWE and estimated pulmonary arterial systolic pressure (ePASP) emerged as the best predictor of clinical outcomes (AUC = 0.910).

Conclusions:

• Myocardial work parameters derived from PSL are valuable emerging markers for cardiac function in PH.
• The combined assessment of RVGWE and ePASP provides a robust tool for predicting clinical outcomes in patients with PH.