Tissue Doppler imaging of right ventricular decompensation in pulmonary hypertension.

Congestive Heart Failure
Marc A SimonAngel López-Candales

Abstract

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.

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Jul 19, 2012·Journal of Veterinary Internal Medicine·S M JohnsJ M Gay
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