Open AccessTissue Doppler Imaging of Right Ventricular Decompensation in Pulmonary Hypertension
Author(s) -
Simon Marc A.,
Rajagopalan Navin,
Mathier Michael A.,
Shroff Sanjeev G.,
Pinsky Michael R.,
LópezCandales Angel
Publication year - 2009
Publication title -
congestive heart failure
Language(s) - English
Resource type - Journals
eISSN - 1751-7133
pISSN - 1527-5299
DOI - 10.1111/j.1751-7133.2009.00113.x
Subject(s) - medicine , decompensation , cardiology , pulmonary hypertension , pulmonary artery , doppler imaging , ventricular function , doppler echocardiography , heart failure , cardiac catheterization , pulmonary wedge pressure , blood pressure , diastole
Right ventricular (RV) function is closely linked to outcomes in pulmonary hypertension (PH). The authors sought to evaluate RV myocardial strain in 3 groups of patients: normal, PH with compensated RV function (PH‐C), and PH with decompensated RV function (PH‐D). Fifty‐six patients (aged 56±12 years; 40 women; mean pulmonary artery pressure [MPAP] range, 13–82 mm Hg) underwent right heart catheterization and 2‐dimensional echocardiography with tissue Doppler imaging of the RV. Right atrial pressures were 6±3, 5±2, and 14±4 mm Hg; MPAP values were 19±3, 44±15, and 56±13 mm Hg; pulmonary vascular resistances were 1.4±0.4, 7.9±5.1, and 11.5±6.6 Wood units; and cardiac indices were 3.4±0.9, 2.8±0.8, and 2.2±0.7 L/min/m 2 (P<.05 for all for normal, PH‐C, and PH‐D patients), respectively. RV free wall strain decreased significantly among all 3 groups (−26%±6%, −19%±7%, and −14%±5%; P<.0001). RV free wall strain decreases in PH without hemodynamically decompensated RV function suggesting it may be a preceding step in the development of RV failure. This may be of particular use in following patients sequentially.