Right ventricular wave reflection relate to clinical measures in pulmonary arterial hypertension

Figures & data

Figure 1. Measurement on right ventricular (RV) pressure waveform. RV systolic pressure (RVSP); RV pressure at ‘shoulder’ (RVSPs).

Figure 2. Matrix used to evaluate the relation between change in right ventricular wave reflection (RVWR) and change in 6 minute walk distance (6MWD). Yes means there is a positive relation, for example if RVWR decreases, 6MWD increases and vice versa. No means there is no relation.

Table I. Baseline characteristics presented as median (first and third quartile) or number.

Number of patients	21
Age (years)	43 (38–52)
Gender (female/male; n)	15/6
Aetiology: IPAH/CTD/CTEPH/Other (n)	9/5/3/4
Haemodynamic measurements
RV Systolic pressure (mmHg)	74 (61–91)
RV Diastolic pressure (mmHg)	8 (7–12)
RV waveform reflection (mmHg)	19 (12–27)
Cardiac output (L/min)	4.1 (3.7–4.3)
Pulmonary vascular resistance (WU)	10 (6–13)
Pulmonary vascular elastance	1.2 (0.9–1.8)
Six-min walked distance (m)	470 (300–548)
NT-proBNP (pg/mL)	331 (79–1930)
PAH treatment (n)
Calcium channel blocker	4
Endothelin receptor antagonist	7
Phosphodiesterase type-5 inhibitors	3
Prostanoids	3
No treatment	10

BMI, body mass index; CCB, calcium channel blocker; CTD, connective tissue disease; CTEPH, chronic thromboembolic pulmonary hypertension; IPAH, idiopathic pulmonary arterial hypertension; NT-proBNP, N-terminal of prohormone brain natriuretic peptide; RV, right ventricular; WHO, world health organization.

Table II. Individual changes in RV waveform reflection, walked distance and NT-proBNP.

Pat no	Gender	Change RVWR (mmHg)	Change 6MWD (m)	% Change NT-proBNP (pg/mL)	Matrix RVWR/6MWD	Matrix RVWR/BNP
1	W	2	− 40	− 19	Yes	No
2	M	− 5	48	120	Yes	No
3	W	− 4	40	− 37	Yes	Yes
4	W	− 5	60	− 66	Yes	Yes
5	M	− 7	530	− 94	Yes	Yes
6	W	3	− 75	34	Yes	Yes
7	W	− 8	90	− 93	Yes	Yes
8	W	− 22	70	− 87	Yes	Yes
9	M	− 9	100	− 26	Yes	Yes
10	W	− 11	262	− 55	Yes	Yes
11	M	11	− 30	15	Yes	Yes
12	W	− 2	116	− 41	Yes	Yes
13	W	− 8	140	− 62	Yes	Yes
14	W	− 4	175	− 31	Yes	Yes
15	M	9	101	− 67	No	No
16	W	2	− 300	104	Yes	Yes
17	W	16	− 109	− 23	Yes	No
18	M	− 12	− 40	116	No	Yes
19	W	− 9	135	− 86	Yes	Yes
20	W	− 8	− 38	292	No	Yes
21	W	− 6	90	− 97	Yes	Yes

NT-proBNP, N-terminal of prohormone brain natriuretic peptide; RVWR, Right ventricular wave reflection; 6MWD, 6-minute walk distance.