Table 4.
Comparison of clinical, BNP level, conventional echocardiographic parameters, and longitudinal strain values (LpsS and LpsSR) in different RV segments in two PAH groups: non-worsening and worsening
| Variable | Non-worsening PAH children (n = 13) |
Worsening PAH children (n = 12) |
p |
|---|---|---|---|
| 6MWD (m) | 416.41 ± 68.72 | 380.90 ± 104.00 | 0.341 |
| SpO2 before 6MWT (%) | 86.00 ± 11.11 | 84.30 ± 7.83 | 0.689 |
| SpO2 after 6MWT (%) | 77.41 ± 18.22 | 74.50 ± 11.53 | 0.667 |
| WHO Functional class | 2.38 ± 0.50 | 2.50 ± 0.67 | 0.631 |
| BNP0 level (pg/ml) | 30.53 ± 37.03 | 82.01 ± 74.80 | 0.039 |
| PAPm (mmHg) | 61.53 ± 18.25 | 64.36 ± 17.13 | 0.701 |
| TR (mmHg) | 91.23 ± 31.74 | 96.50 ± 14.05 | 0.602 |
| sRV pressure (mmHg) | 98.61 ± 40.41 | 111.50 ± 14.05 | 0.297 |
| Pericardial effusion | 2/13 (8 %) | 5/12 (20 %) | 0.200 |
| RV-FAC (%) | 41.07 ± 15.10 | 33.08 ± 9.51 | 0.131 |
| RV MPI | 0.26 (0.24,0.39) | 0.35 (0.29,0.59) | 0.129 |
| TAPSE (cm) | 1.93 ± 0.59 | 1.64 ± 0.61 | 0.247 |
| RV S/D ratio | 1.24 ± 0.28 | 1.36 ± 0.39 | 0.367 |
| Indexed RA area (cm2) | 12.63 ± 3.33 | 15.35 ± 15.70 | 0.547 |
| Tej (ms) | 280.50 ± 31.95 | 264.98 ± 29.18 | 0.219 |
| LV-EI | 1.31 ± 0.17 | 1.56 ± 0.26 | 0.010 |
| S’ (cm/s) | 12.83 ± 3.34 | 10.58 ± 3.50 | 0.114 |
| LV-EF | 71.76 ± 11.07 | 70.58 ± 8.86 | 0.771 |
| RV-LpsS (%) | |||
| RV free wall | −17.38 ± 2.51 | −13.66 ± 3.24 | 0.004 |
| Basal RV free wall | −12.69 ± 4.64 | −12.91 ± 4.01 | 0.899 |
| Mid RV free wall | −20.76 ± 4.62 | −14.00 ± 3.13 | 0.0001 |
| Apical RV free wall | −18.69 ± 4.00 | −14.08 ± 4.92 | 0.017 |
| Apex | −19.15 ± 4.25 | −16.25 ± 4.37 | 0.106 |
| IVS | |||
| Apical IVS | −19.69 ± 5.49 | −19.00 (−22.00,−13.00) | 0.337 |
| Mid IVS | −18.30 ± 4.76 | −16.33 ± 6.63 | 0.399 |
| Basal IVS | NA | NA | NA |
| RV-LpsSR(s −1 ) | |||
| RV free wall | −1.16 ± 0.12 | −1.01 ± 0.13 | 0.008 |
| Basal RV free wall | −1.00 ± 0.19 | −1.00 ± 0.09 | 0.956 |
| Mid RV free wall | −1.37 ± 0.27 | −1.07 ± 0.29 | 0.013 |
| Apical RV free wall | −1.11 ± 0.12 | −0.97 ± 0.16 | 0.090 |
| Apex | −1.15 ± 0.19 | −1.04 ± 0.18 | 0.166 |
| IVS | |||
| Apical IVS | −1.21 ± 0.32 | −1.20 ± 0.20 | 0.896 |
| Mid IVS | −1.17 ± 0.27 | −1.05 ± 0.34 | 0.372 |
| Basal IVS | NA | NA | NA |
Data are presented as means ± SD or median (25th, 75th percentiles) or as numbers (percentages)
BNP brain natriuretic peptide, FAC fractional area change, IVS interventricular septum, LpsS longitudinal peak systolic strain, LpsSR longitudinal peak systolic strain rate, LV-EF left ventricular ejection fraction, LV-EI left ventricular eccentricity index, MPI myocardial performance index, NA no available, PAH pulmonary arterial hypertension, PAPm mean pulmonary arterial pressure, RA right atrium, RV right ventricle, S’ tricuspid annular systolic velocity, S/D ratio systolic/diastolic ratio, SpO 2 oxygen saturation, sRV pressure systolic right ventricular pressure, TAPSE tricuspid annular plane systolic excursion, Tej pulmonary ejection time, TR tricuspid regurgitation, 6MWD 6-min walk distance