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Grönlund, Christer
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Nyman, E., Vanoli, D., Näslund, U. & Grönlund, C. (2019). Inter-sonographer reproducibility of carotid ultrasound plaque detection using Mannheim consensus in subclinical atherosclerosis. Clinical Physiology and Functional Imaging
Open this publication in new window or tab >>Inter-sonographer reproducibility of carotid ultrasound plaque detection using Mannheim consensus in subclinical atherosclerosis
2019 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097XArticle in journal (Refereed) Published
Abstract [en]

Aims: To determine the inter-sonographer reproducibility of carotid ultrasound plaque detection using Mannheim consensus in a subclinical population and evaluate associations related to the reproducibility.

Methods and results: Bilateral ultrasound screening for carotid plaques defined by Mannheim consensus was performed on 106 subclinical participants. Two different sonographers scanned the same participant, and reproducibility of plaque detection was measured by Cohens kappa. Associations with reproducibility were evaluated by comparing wall, and plaque characteristics between subjects with plaques identified in one and both scans. In general, the inter-sonographer reproducibility of plaque detection was substantial with a kappa value of 0 center dot 70 (95% CI 0 center dot 60-0 center dot 80). Plaques detected in only one scan had significantly lower plaque area and plaque thickness (6 center dot 82 mm(2) and 1 center dot 45 mm) as compared to plaques detected in both scans (11 center dot 65 mm(2) and 1 center dot 96 mm, P<0 center dot 001).

Conclusion: Minor carotid plaques contribute to decreased reproducibility as compared to large plaques when screening for subclinical atherosclerosis using Mannheim consensus. Using an alternative plaque definition based on plaque thickness >1.5 mm and plaque area >10 mm(2) could increase the reproducibility of plaque detection in subclinical atherosclerosis.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
carotid, inter-sonographer, plaque, reproducibility, subclinical, ultrasound
National Category
Physiology
Identifiers
urn:nbn:se:umu:diva-165443 (URN)10.1111/cpf.12602 (DOI)000493037200001 ()31605665 (PubMedID)
Available from: 2019-11-27 Created: 2019-11-27 Last updated: 2019-11-27
Näslund, U., Ng, N., Lundgren, A., Fhärm, E., Grönlund, C., Johansson, H., . . . Norberg, M. (2019). Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA): a pragmatic, open-label, randomised controlled trial. The Lancet, 393(10167), 133-142
Open this publication in new window or tab >>Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA): a pragmatic, open-label, randomised controlled trial
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2019 (English)In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 393, no 10167, p. 133-142Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Primary prevention of cardiovascular disease often fails because of poor adherence among practitioners and individuals to prevention guidelines. We aimed to investigate whether ultrasound-based pictorial information about subclinical carotid atherosclerosis, targeting both primary care physicians and individuals, improves prevention.

METHODS: Visualization of asymptomatic atherosclerotic disease for optimum cardiovascular prevention (VIPVIZA) is a pragmatic, open-label, randomised controlled trial that was integrated within the Västerbotten Intervention Programme, an ongoing population-based cardiovascular disease prevention programme in northern Sweden. Individuals aged 40, 50, or 60 years with one or more conventional risk factors were eligible to participate. Participants underwent clinical examination, blood sampling, and ultrasound assessment of carotid intima media wall thickness and plaque formation. Participants were randomly assigned 1:1 with a computer-generated randomisation list to an intervention group (pictorial representation of carotid ultrasound plus a nurse phone call to confirm understanding) or a control group (not informed). The primary outcomes, Framingham risk score (FRS) and European systematic coronary risk evaluation (SCORE), were assessed after 1 year among participants who were followed up. This study is registered with ClinicalTrials.gov, number NCT01849575.

FINDINGS: 3532 individuals were enrolled between April 29, 2013, and June 7, 2016, of which 1783 were randomly assigned to the control group and 1749 were assigned to the intervention group. 3175 participants completed the 1-year follow-up. At the 1-year follow-up, FRS and SCORE differed significantly between groups (FRS 1·07 [95% CI 0·11 to 2·03, p=0·0017] and SCORE 0·16 [0·02 to 0·30, p=0·0010]). FRS decreased from baseline to the 1-year follow-up in the intervention group and increased in the control group (-0·58 [95% CI -0·86 to -0·30] vs 0·35 [0·08 to 0·63]). SCORE increased in both groups (0·13 [95% CI 0·09 to 0·18] vs 0·27 [0·23 to 0·30]).

INTERPRETATION: This study provides evidence of the contributory role of pictorial presentation of silent atherosclerosis for prevention of cardiovascular disease. It supports further development of methods to reduce the major problem of low adherence to medication and lifestyle modification.

Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-154318 (URN)10.1016/S0140-6736(18)32818-6 (DOI)000455437100026 ()30522919 (PubMedID)
Funder
Västerbotten County Council, Dnr ALFVLL-298001Swedish Research Council, Dnr 521-2013-2708Swedish Research Council, 2016-01891Swedish Heart Lung Foundation, Dnr 20150369Swedish Heart Lung Foundation, 20170481
Available from: 2018-12-17 Created: 2018-12-17 Last updated: 2019-02-22Bibliographically approved
Jashari, F., Ibrahimi, P., Johansson, E., Grönlund, C., Wester, P. & Henein, M. Y. (2018). Carotid IM-GSM is better than IMT for identifying patients with multiple arterial disease. Scandinavian Cardiovascular Journal, 52(2), 93-99
Open this publication in new window or tab >>Carotid IM-GSM is better than IMT for identifying patients with multiple arterial disease
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2018 (English)In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 52, no 2, p. 93-99Article in journal (Refereed) Published
Abstract [en]

Objective. Atherosclerosis is a systemic inflammatory disease that can affect more than one arterial bed simultaneously. The aim of this study was to determine the relationship between ultrasound markers of atherosclerosis and multiple arterial disease. Design. We have included 87 currently asymptomatic carotid disease patients (mean age 69 +/- 6 year, 34% females) in this study. Intima media thickness (IMT) and intima media-grey scale median (IM-GSM) were measured in the common carotid artery (CCA), and correlated with previous and/or current atherosclerotic vascular disease in the coronary, carotid and lower extremities. Patients were divided into three groups: (1) asymptomatic, (2) previous symptoms in one arterial territory and (3) previous symptoms in multiple arterial territories. Results. Patients with previous disease in the coronary arteries had higher IMT (p=.034) and lower IM-GSM (p<.001), and those with prior stroke had lower IM-GSM (p=.007). Neither IMT nor IM-GSM was different between patients with and without previous lower extremity vascular disease. IM-GSM was significantly different between groups, it decreased significantly with increasing number of arterial territories affected (37.7 +/- 15.4 vs. 29.3 +/- 16.4 vs. 20.7 +/- 12.9) p<.001, for asymptomatic, symptoms in one and in multiple arterial systems, respectively. Conventional IMT was not significantly different between groups p=.49. Conclusion. Carotid IMT was higher and IM-GSM lower in patients with symptomatic nearby arterial territories but not in those with peripheral disease. In contrast to conventional IMT, IM-GSM can differentiate between numbers of arterial territories affected by atherosclerosis, suggesting that it is a better surrogate for monitoring multiple arterial territory disease.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2018
Keywords
Atherosclerosis, carotid artery, intimal-media complex, IMT, IM-GSM
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-146595 (URN)10.1080/14017431.2018.1435903 (DOI)000428305000006 ()29402147 (PubMedID)
Available from: 2018-05-08 Created: 2018-05-08 Last updated: 2019-05-20Bibliographically approved
Khangure, S. R., Benhabib, H., Machnowska, M., Fox, A. J., Grönlund, C., Herod, W., . . . Johansson, E. (2018). Carotid near-occlusion frequently has high peak systolic velocity on Doppler ultrasound. Neuroradiology, 60(1), 17-25
Open this publication in new window or tab >>Carotid near-occlusion frequently has high peak systolic velocity on Doppler ultrasound
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2018 (English)In: Neuroradiology, ISSN 0028-3940, E-ISSN 1432-1920, Vol. 60, no 1, p. 17-25Article in journal (Refereed) Published
Abstract [en]

Purpose: Carotid near-occlusion is a tight atherosclerotic stenosis of the internal carotid artery (ICA) resulting in decrease in diameter of the vessel lumen distal to the stenosis. Near-occlusions can be classified as with or without full collapse, and may have high peak systolic velocity (PSV) across the stenosis, mimicking conventional > 50% carotid artery stenosis. We aimed to determine how frequently near-occlusions have high PSV in the stenosis and determine how accurately carotid Doppler ultrasound can distinguish high-velocity near-occlusion from conventional stenosis.

Methods: Included patients had near-occlusion or conventional stenosis with carotid ultrasound and CT angiogram (CTA) performed within 30 days of each other. CTA examinations were analyzed by two blinded expert readers. Velocities in the internal and common carotid arteries were recorded. Mean velocity, pulsatility index, and ratios were calculated, giving 12 Doppler parameters for analysis.

Results: Of 136 patients, 82 had conventional stenosis and 54 had near-occlusion on CTA. Of near-occlusions, 40 (74%) had high PSV (≥ 125 cm/s) across the stenosis. Ten Doppler parameters significantly differed between conventional stenosis and high-velocity near-occlusion groups. However, no parameter was highly sensitive and specific to separate the groups.

Conclusion: Near-occlusions frequently have high PSV across the stenosis, particularly those without full collapse. Carotid Doppler ultrasound does not seem able to distinguish conventional stenosis from high-velocity near-occlusion. These findings question the use of ultrasound alone for preoperative imaging evaluation.

Keywords
Carotid stenosis, Ultrasonography, X-ray computed tomography, Angiography, Internal carotid artery, LONG ER, 1988, BIOMETRICS, V44, P837 ftus IM, 1998, EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, V16, P489 rst J., 2015, AMERICAN JOURNAL OF NEURORADIOLOGY, V36, P1978 n Reutern Gerhard-Michael, 2012, STROKE, V43, P916 clerc X, 1999, RADIOLOGY, V210, P673 naboldo C, 1991, European journal of vascular surgery, V5, P415
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-144100 (URN)10.1007/s00234-017-1938-4 (DOI)000419127000004 ()29177789 (PubMedID)
Available from: 2018-02-02 Created: 2018-02-02 Last updated: 2019-11-19Bibliographically approved
Lindkvist, M., Granåsen, G. & Grönlund, C. (2018). Precontractile optical response during excitation-contraction in human muscle revealed by non-invasive high-speed spatiotemporal NIR measurement. Scientific Reports, 8, Article ID 213.
Open this publication in new window or tab >>Precontractile optical response during excitation-contraction in human muscle revealed by non-invasive high-speed spatiotemporal NIR measurement
2018 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 8, article id 213Article in journal (Refereed) Published
Abstract [en]

During muscle contraction the excitation-contraction process mediates the neural input and mechanical output. Proper muscle function and body locomotion depends on the status of the elements in the same process. However, non-invasive and in-vivo methods to study this are not available. Here we show the existence of an optical response occurring during the excitation-contraction process in human biceps brachii muscle. We developed a non-invasive instrument from a photodiode array and light emitting diodes to detect spatially propagating (similar to 5 m/s) and precontractile (similar to 6 ms onset) optical signals closely related to the action potential during electrostimulation. Although this phenomenon was observed 60 years ago on isolated frog muscle cells in the lab, it has not been shown in-vivo before now. We anticipate our results to be a starting point for a new category in-vivo studies, characterising alterations in the excitation-contraction process in patients with neuromuscular disease and to monitor effects of therapy.

Place, publisher, year, edition, pages
Nature Publishing Group, 2018
National Category
Neurology Neurosciences
Identifiers
urn:nbn:se:umu:diva-144397 (URN)10.1038/s41598-017-18455-y (DOI)000419659800048 ()29317688 (PubMedID)
Available from: 2018-02-13 Created: 2018-02-13 Last updated: 2019-05-17Bibliographically approved
Nyman, E., Lindqvist, P., Näslund, U. & Grönlund, C. (2018). Risk marker variability in subclinical carotid plaques based on ultrasound is influenced by cardiac phase, echogenicity and size. Ultrasound in Medicine and Biology, 44(8), 1742-1750
Open this publication in new window or tab >>Risk marker variability in subclinical carotid plaques based on ultrasound is influenced by cardiac phase, echogenicity and size
2018 (English)In: Ultrasound in Medicine and Biology, ISSN 0301-5629, E-ISSN 1879-291X, Vol. 44, no 8, p. 1742-1750Article in journal (Refereed) Published
Abstract [en]

Identification of risk markers based on quantitative ultrasound texture analysis of carotid plaques has the ability to define vulnerable components that correlate with increased cardiovascular risk. However, data describing factors with the potential to influence the measurement variability of risk markers are limited. The aim of this study was to evaluate the influence of electrocardiogram-guided image selection, plaque echogenicity and area on carotid plaque risk markers and their variability in asymptomatic carotid plaques. Plaque risk markers were measured in 57 plaques during three consecutive heartbeats at two cardiac cycle time instants corresponding to the electrocardiogram R-wave (end diastole) and end of T-wave (end systole), resulting in six measurements for each plaque. Risk marker variability was quantified by computing the coefficient of variation (CV) across the three heartbeats. The CV was significantly higher for small plaques (area <15 mm2, 10%) than for large plaques (area >15 mm2, 6%) (p <0.001) in measurements of area, and the CV for measurements of gray-scale median were higher for echolucent plaques (<40, 15%) than for echogenic plaques (>40, 9%) (p <0.001). No significant differences were found between systole and diastole for the mean of any risk marker or the corresponding CV value. However, in a sub-analysis, the echolucent plaques were found to have a higher CV during systole compared with diastole. The variability also caused plaque type reclassification in 16% to 25% of the plaques depending on cutoff value. The results of this study indicate that echolucent and small plaques each contribute to increased risk marker variability. Based on these results, we recommend that measurements in diastole arc preferred to reduce variation, although we found that it may not be possible to characterize small plaques accurately using contemporary applied risk markers. 

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Carotid plaque, Risk markers, Cardiac cycle, Echogenicity, Size, Classification
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-150664 (URN)10.1016/j.ultrasmedbio.2018.03.013 (DOI)000436561500018 ()29735317 (PubMedID)2-s2.0-85046670751 (Scopus ID)
Funder
Swedish Research Council, 2015-04461
Available from: 2018-08-28 Created: 2018-08-28 Last updated: 2019-05-21Bibliographically approved
Henein, M. Y., Grönlund, C., Tossavainen, E., Söderberg, S., Gonzalez, M. & Lindqvist, P. (2017). Right and left heart dysfunction predict mortality in pulmonary hypertension. Clinical Physiology and Functional Imaging, 37(1), 45-51
Open this publication in new window or tab >>Right and left heart dysfunction predict mortality in pulmonary hypertension
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2017 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 37, no 1, p. 45-51Article in journal (Refereed) Published
Abstract [en]

In pulmonary hypertension (PH), the right heart dysfunction is a strong predictor of adverse clinical outcome, while the role of the left heart is not fully determined. The aim of this study was to identify predictors of mortality in precapillary PH including measures of both right and left heart function. We studied 34 patients (mean age 64 ± 13, range 31-82 years, 24 females) with precapillary PH, all of whom underwent detailed Doppler echocardiographic examination of the right and left heart function using conventional and speckle-tracking echocardiography. Patients were followed up for up to 8 years (mean 4·2 ± 1·9 years). At follow-up, 16 patients survived. Left ventricular (LV) filling time (P = 0·007), pulmonary artery acceleration time (P = 0·009), right atrial pressure (RAP) (P<0·001) and tricuspid regurgitation (TR) severity (P = 0·007) were worse in the deceased group. RV global longitudinal strain (GLS) (P = 0·001), RAP (P≤0·001), LV filling time (P<0·001) and TR severity (P<0·001) were the most accurate predictors, having the largest AUC (>0·65) and carried the highest risk for mortality (P<0·001 for all). The strongest predictors of mortality in precapillary PH indirectly reflect both left and right heart dysfunction including atrial structure and function disturbances. While an interaction pattern is observed, it needs to be confirmed in a larger cohort.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2017
Keywords
diastolic function, Doppler echocardiography, left heart function, precapillary pulmonary hypertension, right heart function
National Category
Cardiac and Cardiovascular Systems
Research subject
cardiovascular disease
Identifiers
urn:nbn:se:umu:diva-112221 (URN)10.1111/cpf.12266 (DOI)000390688200007 ()26096286 (PubMedID)
Available from: 2015-12-04 Created: 2015-12-04 Last updated: 2019-05-22Bibliographically approved
Nyman, E., Vanoli, D., Grönlund, C., Näslund, U. & Lindqvist, P. (2016). Area measurement of carotid plaque comparing B-MODE, Doppler color and contrast-enhanced ultrasound imaging. Paper presented at Congress of the European-Atherosclerosis-Society (EAS), MAY 29-JUN 01, 2016, Innsbruck, AUSTRIA. Atherosclerosis, 252, E191-E191
Open this publication in new window or tab >>Area measurement of carotid plaque comparing B-MODE, Doppler color and contrast-enhanced ultrasound imaging
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2016 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 252, p. E191-E191Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Objectives: Carotid plaque characteristic analysis are suggested to improve risk stratification. Plaque area and echolucent plaques have shown to correlate with increased risk for cardiovascular diseases. A limitation with B-mode imaging is the uncertainty that the whole plaque area is identified, primarily on echolucent plaques. Contrast-enhanced ultrasound (CEUS) is used to improve carotid imaging including better plaque area measurement. Aim: Evaluate if CEUS could improve accurate plaque area measurement compared with B-mode and Doppler color flow imaging. Methods: The study included 28 participants (50% females, mean age 58 years) with identified asymptomatic carotid plaques. We performed B-mode, Doppler color and CEUS ultrasound imaging whereas the plaque area was manually outdrawn by a single operator. Plaques were also subjectively classified as 1 echogenic, 2 echolucent, or 3 mixed plaques. Results: We did not find a significant difference in plaque area measurements between different ultrasound image modalities having all plaque types included. In the group of echolucent plaques (n= 11) we found a significant different between B-mode and CEUS (p=0.049) and also between B-mode and Doppler color imaging (p=0.039) (Illustrated in Fig 1). Conclusions: Echolucent plaque can be underestimated with B-mode imaging. Use of contrast-enhanced ultrasound should be considered in carotid plaque imaging on echolucent plaques when plaque outline is difficult to identify.

Place, publisher, year, edition, pages
Elsevier, 2016
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-130113 (URN)10.1016/j.atherosclerosis.2016.07.881 (DOI)000388978400649 ()
Conference
Congress of the European-Atherosclerosis-Society (EAS), MAY 29-JUN 01, 2016, Innsbruck, AUSTRIA
Note

Meeting Abstract: EAS16-0052, Vascular Biology: Myocardial Infarction, Stroke, Peripheral Vascular Disease

Available from: 2017-01-13 Created: 2017-01-11 Last updated: 2018-06-09Bibliographically approved
Jashari, F., Ibrahimi, P., Bajraktari, G., Grönlund, C., Wester, P. & Henein, M. Y. (2016). Carotid plaque echogenicity predicts cerebrovascular symptoms: a systematic review and meta-analysis. European Journal of Neurology, 23(7), 1241-1247
Open this publication in new window or tab >>Carotid plaque echogenicity predicts cerebrovascular symptoms: a systematic review and meta-analysis
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2016 (English)In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 23, no 7, p. 1241-1247Article in journal (Refereed) Published
Abstract [en]

Background and purpose: Many reports have shown an association between hypoechoic (echolucent) carotid atherosclerotic plaques and unstable features. In this meta-analysis our aim was to determine the role of carotid plaque echogenicity in predicting future cerebrovascular (CV) symptoms.

Methods: Electronic databases (PubMed, MEDLINE, EMBASE and Cochrane Center Register) up to September 2015 were systematically searched. Studies with ultrasound-based characterization of carotid artery plaque echogenicity and its association with focal neurological symptoms of vascular origin were eligible for analysis. In the meta-analysis, heterogeneity was measured usingI2 statistics and publication bias was evaluated using the Begg–Mazumdar test. In addition several comparisons between subgroups were performed.

Results: Of 1387 identified reports, eight studies with asymptomatic patients and three studies with symptomatic patients were meta-analyzed. Pooled analysis showed an association between echolucent carotid plaques and future CV events in asymptomatic patients [relative risk 2.72 (95% confidence interval 1.86–3.96)] and recurrent symptoms in symptomatic patients [relative risk 2.97 (95% confidence interval 1.85–4.78)]. The association was preserved for all stenosis degrees in asymptomatic patients, whilst patients with echolucent plaques and severe stenosis were at higher risk of future events. Also, computer-assisted methods for assessment of carotid plaque echogenicity and studies analyzing ultrasound data collected after the year 2000 showed better prediction.

Conclusions: In asymptomatic and symptomatic patients, analysis of carotid plaque echogenicity could identify those at high risk of CV events.

Keywords
carotid atherosclerosis, cerebrovascular symptoms, grey scale median, plaque echogenicity, trasound
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-124230 (URN)10.1111/ene.13017 (DOI)000378431100022 ()27106563 (PubMedID)
Available from: 2016-08-01 Created: 2016-07-28 Last updated: 2019-05-16Bibliographically approved
Tossavainen, E., Henein, M. Y., Grönlund, C. & Lindqvist, P. (2016). Left Atrial Intrinsic Strain Rate Correcting for Pulmonary Wedge Pressure Is Accurate in Estimating Pulmonary Vascular Resistance in Breathless Patients. Echocardiography, 33(8), 1156-1165
Open this publication in new window or tab >>Left Atrial Intrinsic Strain Rate Correcting for Pulmonary Wedge Pressure Is Accurate in Estimating Pulmonary Vascular Resistance in Breathless Patients
2016 (English)In: Echocardiography, ISSN 0742-2822, E-ISSN 1540-8175, Vol. 33, no 8, p. 1156-1165Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: We hypothesized that left atrial deformation during atrial systole (LASRa) correlates with pulmonary capillary wedge pressure (PCWP), thus enabling echo-derived pulmonary vascular resistance (PVR) estimation in a wide range of different subsets of patients.

BACKGROUND: Various etiologies of pulmonary hypertension (PH) have different mechanisms and treatments for breathlessness. Irrespective of the location of the underlying pulmonary vascular pathology, pre- or postcapillary, the resulting PH is fairly easy to assess by Doppler echocardiography, but PVR remains a challenge.

METHODS: We prospectively included 46 patients (mean age 61 ± 13 years) in sinus rhythm, who underwent right heart catheterization because of dyspnea. According to the NICE guidelines classification, 22 belonged to group 1 pulmonary artery hypertension (PAH), 19 belonged to group 2 congestive heart failure (CHF), 1 belonged to group 4 chronic thromboembolic pulmonary hypertension (CTEPH), and 4 had normal hemodynamics. Simultaneous Doppler echocardiography using spectral, tissue Doppler, and speckle tracking echocardiography techniques for assessing LA structure and function was performed.

RESULTS: PCWPrhc correlated with LASRa (r(2) = 0.65, P < 0.001). PCWPecho was calculated using the equation (PCWPecho = 26.12 - 11.09 × LASRa), and the resulting PVR echo strongly correlated with the respective catheter-based measurements PVRrhc (r(2) = 0.69. P < 0.001) with a sensitivity of 85% and specificity of 74% identifying a PVR ≥ 3 WU.

CONCLUSIONS: Left atrial strain rate during atrial systole correlates closely with pulmonary capillary wedge pressure and consequently the calculated pulmonary vascular resistance, irrespective of the etiology of PH.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2016
Keywords
echocardiography, strain rate, left atrium
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-120756 (URN)10.1111/echo.13226 (DOI)000383354900005 ()27144613 (PubMedID)
Available from: 2016-05-20 Created: 2016-05-20 Last updated: 2019-05-10Bibliographically approved
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