Determinants of the rate of right ventricular pressure rise by Doppler echocardiography: potential value in the assessment of right ventricular function.
Tricuspid regurgitation (TR) is common and the rate of right ventricular (RV) pressure rise in early systole can be obtained from the TR velocity profile. Right ventricular function has important implications in patients with valvular heart disease. Fifty five patients with mild or moderate TR and a wide range of pulmonary artery (PA) pressures were studied. The RV dP/dt was obtained as the ratio of the calculated rise in RV pressure from 0.5 m/s to 1.5 m/s of the TR velocity signal (8 mmHg based on simplified Bernoulli equation) to the time taken for this change. The RV dP/dt correlated positively with PA systolic pressure (r = 0.73, p < 0.001), tricuspid anular plane systolic excursion which is an echocardiographic index of RV ejection systolic function (r = 0.45, p < 0.001) and left ventricular (LV) fractional shortening (r = 0.40, p < 0.01). Multivariate analysis showed that all these three parameters independently influenced RV dP/dt (multivariate R = 0.83) accounting for 69% of its variability. In conclusion, it is suggested that right ventricular dP/dt is easily obtainable from Doppler TR velocity signal. It is influenced independently in a positive manner by PA systolic pressure and RV and LV systolic function. Despite its predominant dependence on PA systolic pressure, it may give useful insight into RV systolic function for a given level of PA pressure. It may also be useful for longitudinal follow up of the RV function in patients with heart disease.
Pai
R G
RG
Department of Cardiology, Jerry L. Pettis Veterans Hospital, Loma Linda, CA 92357.
Bansal
R C
RC
Shah
P M
PM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011651:Pulmonary Artery / Q000503:physiopathology; D013599:Systole; D014262:Tricuspid Valve Insufficiency / Q000503:physiopathology*; D016278:Ventricular Function, Right