Abstract Objective: Real-time three-dimensional echocardiography(RT-3DE) was used to assess reverse remodeling of the right ventricle(RV) following short-term therapy in patients with connective tissue disease associated pulmonary arterial hypertension(CTD-PAH). Methods: Consecutive CTD patients admitted to the Department of Rheumatology and Immunology of our hospital from July 2015 to December 2018 were selected. According to the 2015 ESC/ERS guidelines for pulmonary hypertension(PH), those patients with “high” PH possibility were enrolled. Echocardiographic parameters derived from conventional echocardiography and RT-3DE including pulmonary arterial systolic pressure(PASP), right ventricular end-diastolic volume index(RVEDVi), end-systolic volume index(RVESVi) and ejection fraction(RVEF) were measured. Clinical data were collected including the types of CTD diseases, drug treatment, WHO functional classification, BNP, etc. The patients were followed up for 3 to 6 months after the initial enrolled. Clinical improvement was defined according to the follow-up clinical situation, and the RV reverse remodeling in patients with clinical improvement was analyzed. Results: After an average follow-up time of 4.2±0.9 months, 56.1% of the 57 patients achieved clinical improvement, and the BNP and PASP in the improved group were lower than those in the non-improved group at baseline(P<0.01). During the follow-up of the improved group, WHO-FC, BNP and PASP were significantly decreased, RV volume was significantly decreased, and RVEF was significantly increased(P<0.001). The change of PASP was not significantly correlated with the change of BNP level, while the change of RV volume and RVEF were significantly correlated with the change of BNP level, among which RVESVi had the best correlation with BNP(r=0.651, P<0.001). Conclusions: RV reverse remodeling in CTD-PAH patients is significantly correlated with BNP reduction and RVESVi derived from RT-3DE can be used as a good indicator to evaluate RV reverse remodeling.
BAI Yang,LIU Juan-juan,NING Hong-xia, et al. Reverse right ventricular remodeling in patients with connective tissue disease associated
pulmonary arterial hypertension evaluated by RT-3DE[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2020, 31(3): 175-179.
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