Right ventricular diastolic dysfunction in arterial systemic hypertension: analysis by pulsed tissue Doppler.
OBJECTIVE
This study analyses right ventricular longitudinal function in arterial systemic hypertension by pulsed tissue Doppler.


RESULTS
Thirty normotensives and 30 hypertensives, free of cardiac drugs, underwent standard Doppler echocardiography and pulsed tissue Doppler of right ventricular lateral tricuspid annulus and left ventricular lateral mitral annulus. By tissue Doppler, systolic and diastolic measurements were obtained. Hypertensives had higher left ventricular mass and impaired Doppler diastolic indexes, without changes of global systolic function. Tissue Doppler showed reduction of right ventricular E/A ratio and prolongation of relaxation time in comparison with controls (both P<0.00001). In the overall population, the length of tissue Doppler derived right ventricular relaxation time was positively related to right ventricular anterior wall thickness while right ventricular E/A ratio was positively related to E/A ratio of left ventricular mitral annulus (both P<0.00001). These relations remained significant even after adjusting for clinical and echocardiographic confounders by separate multivariate models.


CONCLUSIONS
Arterial systemic hypertension is associated to right ventricular longitudinal diastolic dysfunction. This dysfunction involves the prolongation of active relaxation, which is independently associated with the degree of right ventricular hypertrophy and the impairment of passive wall properties, which is mainly due to ventricular interaction occurring under left ventricular pressure overload conditions.
PhD in Medical-Surgical Physiopathology of Cardiopulmunar and Respiratory System and Associated Biotechnologies, Second University of Naples, Italy
S
S
Cicala
M
M
Galderisi
P
P
Caso
A
A
Petrocelli
A
A
D'Errico
O
O
de Divitiis
R
R
Calabrò
D000328:Adult; D003971:Diastole; D015150:Echocardiography, Doppler; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging; D013599:Systole; D014261:Tricuspid Valve / Q000000981:diagnostic imaging; D018617:Ultrasonography, Doppler, Pulsed; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging*; D016278:Ventricular Function, Right