Noninvasive pulmonary transit time: a new parameter for general cardiac performance

A.G.W. de Lepper (Corresponding author), I.H.F. Herold, S. Saporito, R.A. Bouwman, M. Mischi, H.P.J. Korsten, K.D. Reesink, P. Houthuizen

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Abstract

Introduction: Pulmonary transit time (PTT) assessed with contrast-enhanced ultrasound (CEUS) is a novel tool to evaluate cardiac function. PTT represents the time for a bolus of contrast to pass from the right to the left ventricle, measured according to the indicator dilution principles using CEUS. We investigated the hypothesis that PTT is a measure of general cardiac performance in patient populations eligible for cardiac resynchronization therapy (CRT). Methods: The study population consisted of heart failure patients referred for CRT with NYHA class II–IV, left ventricular ejection fraction (LVEF)≤35% and QRS≥120 ms. CEUS, ECG, and blood were analyzed, and participants completed a quality of life questionnaire at baseline and 3 months after CRT implantation. Normalized PTT (nPTT) was calculated to compensate for the heart rate. Correlations were assessed with Pearson's or Spearman's coefficients and stratified for rhythm and NYHA class. Results: The study population consisted of 94 patients (67 men) with a mean age of 70±8.9 years. (n)PTT was significantly correlated with left ventricular parameters (rs=−.487, P<.001), right ventricular parameters (r=−.282, P=.004), N-terminal pro-B-type natriuretic peptide (NT-proBNP) (rs=.475, P<.001), and quality of life (rs=.364, P<.001). Stronger significant correlations were found in patients in sinus rhythm. Conclusion: CEUS-derived PTT and nPTT correlate to a fair degree with measures of systolic and diastolic function, NT-pro-BNP, and quality of life. As CEUS-derived PTT can be obtained easily, noninvasively and at the bedside, it is a promising future measure of general cardiac performance.

Original languageEnglish
Pages (from-to)1138-1145
Number of pages8
JournalEchocardiography
Volume34
Issue number8
DOIs
Publication statusPublished - 1 Aug 2017

Keywords

  • contrast echocardiography
  • diastolic dysfunction
  • heart failure
  • left ventricular function
  • pulmonary transit time
  • right ventricular function
  • systolic function
  • Blood Volume/physiology
  • Prognosis
  • Diastole
  • Contrast Media/pharmacology
  • Humans
  • Male
  • Stroke Volume/physiology
  • Heart Atria/diagnostic imaging
  • Systole
  • Cardiac Resynchronization Therapy/methods
  • Echocardiography/methods
  • Female
  • Reproducibility of Results
  • Ventricular Function, Left/physiology
  • Blood Volume Determination
  • Heart Failure/physiopathology
  • Aged
  • Heart Ventricles/diagnostic imaging

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