Right Ventricular and Pulmonary Vascular Function are Influenced by Age and Volume Expansion in Healthy Humans

Emil Wolsk*, Rine Bakkestrøm, Charlotte Burup Kristensen, Katrine Aagaard Myhr, Jakob H. Thomsen, Louise Balling, Mads J. Andersen, Jordi S. Dahl, Sanjiv J. Shah, Finn Gustafsson, Christian Hassager, Jacob E. Møller

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Patients with heart failure (HF) often show signs of right ventricular (RV) dysfunction. The RV function of coupled with the pulmonary circulation (tricuspid annular plane systolic excursion [TAPSE]/pulmonary arterial systolic pressure [PASP]) has been shown to divide HF patients into distinct prognostic strata, but less is known about which factors influence this prognostic marker, and whether those factors can be modified. We sought to obtain normative values and discern the individual effects of age, sex, and fluid overload on RV function. Methods and Results: Sixty healthy subjects aged 20–80 years were enrolled in this prospective study. Right heart catheterization with hemodynamic measurements were performed at rest after a rapid saline solution infusion (10 mL/kg, 150 mL/min). Linear regression and Spearman correlation models were used to estimate associations between TAPSE/PASP and relevant variables. In healthy persons of all ages, the median (5th–95th percentiles) normative TASPE-PASP ratio was 1.25 (0.81–1.78) mm/mm Hg. The correlation between progressive age and declining TAPSE/PASP was significant (r = −0.35; P =.006). Sex did not influence TAPSE/PASP (P =.30). Rapid fluid expansion increased central venous pressure from 5 ± 2 mm Hg to 11 ± 4 mm Hg after fluid infusion (P <.0001). This resulted in a 32% decrease in the TAPSE-PASP ratio after fluid infusion, compared to baseline (P <.0001). Conclusions: The TAPSE-PASP ratio was affected by age, but not sex. TAPSE/PASP is not only a reflection of intrinsic RV function and pulmonary vascular coupling, but fluid status also dynamically affects this index of RV function. Normative values with invasive measurements were obtained for future assessment of HF patients.

Original languageEnglish (US)
Pages (from-to)51-59
Number of pages9
JournalJournal of Cardiac Failure
Volume25
Issue number1
DOIs
StatePublished - Jan 2019

Keywords

  • Heart failure
  • TAPSE/PASP
  • age
  • fluid bolus
  • healthy
  • hemodynamics
  • right heart function
  • sex

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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