title: Retrospective study of pulmonary hypertensive patients: is right ventricular myocardial performance index a vital prognostic factor?
abstract: BACKGROUND
  Right ventricular function is a determinant of prognosis and survival in patients with pulmonary hypertension. The pulmonary hypertensive right ventricle has a complex shape. Transthoracic two-dimensional echocardiography is the primary examination for demonstrating right ventricular impairment. Nowadays, many indices have been linked with pulmonary hypertension. The myocardial performance index (MPI), which may be determined by both conventional Doppler and tissue Doppler imaging (TDI), is one of these.
  
  
  METHODS
  Ninety-three patients with pulmonary hypertension were examined retrospectively over 3 years' treatment. The relationship between MPI and right ventricular impairment was studied, as well as the correlation with various echocardiographic determinants. In addition, we examined the correlation between conventional echocardiography and tissue Doppler imaging with reference to the MPI.
  
  
  RESULTS
  MPI had a statistically significant relationship with the visual estimation of right ventricular impairment (r = 0.714, p = 0.001), the degree of pulmonary regurgitation (r = 0.155, p = 0.048), left ventricular eccentricity index (r = 0.299, p = 0.001 in systole) and the presence of pericardial effusion (r = 0.199, p = 0.008), while it was inversely correlated with left ventricular fractional shortening (r = -0.284, p = 0.001). However, the index had no correlation with tricuspid regurgitant velocity, right ventricular acceleration time or right atrial volume. There was significant agreement between the MPI measured by conventional Doppler echocardiography and by TDI (r = 0.83, p < 0.001; mean value -0.10, SD 0.2). Finally, some patients showed a significant decrease in tricuspid regurgitant velocity and MPI during their treatment.
  
  
  CONCLUSIONS
  Right ventricular MPI has a good correlation with several parameters and can be a good prognostic factor for right ventricular impairment in patients with pulmonary hypertension.
authors.affiliation: Department of Cardiology and Pulmonary Hypertension Service, Hammersmith Hospital, Imperial College School of Medicine, National Heart & Lung Institute, London, UK. jgrapsa@gmail.com
authors.forename: Ioulia
authors.initials: I
authors.lastname: Grapsa
authors.forename: Harry
authors.initials: H
authors.lastname: Pavlopoulos
authors.forename: David
authors.initials: D
authors.lastname: Dawson
authors.forename: J Simon R
authors.initials: JS
authors.lastname: Gibbs
authors.forename: Petros
authors.initials: P
authors.lastname: Nihoyannopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018618:Echocardiography, Doppler, Color / Q000379:methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology