title: Myocardial tissue Doppler-based indexes to distinguish right ventricular volume overload from right ventricular pressure overload.
abstract: The objective of this study was to develop tissue Doppler parameters that could be used to differentiate right ventricular (RV) volume overload from RV pressure overload. The RV-pressure-overload group consisted of 40 patients with severe pulmonary hypertension, and the RV-volume-overload group consisted of 40 patients who had an atrial septal defect without evidence of right-to-left shunt, significant pulmonary hypertension, or Eisenmenger's complex. Another 40 healthy subjects were enrolled and served as a control group. Routine echocardiography and tissue Doppler imaging were performed. RV myocardial performance index was determined based on data collected during tissue Doppler imaging over the lateral tricuspid annulus. In patients with RV pressure overload, tissue Doppler parameters showed characteristically lower systolic velocity over the tricuspid annulus (RV myocardial systolic wave [Sm]) and longer isovolumic relaxation time (RV-IVRT). Nevertheless, in patients with RV volume overload, RV-Sm increased significantly, but early-diastolic velocity over tricuspid annulus was relatively low. In conclusion, RV-MPI, RV-Sm/early-diastolic velocity over tricuspid annulus, and RV-IVRT/RV-Sm were all useful to differentiate RV pressure overload from volume overload, although RV-IVRT/RV-Sm was the best parameter, with excellent sensitivity and specificity.
authors.affiliation: Department of Internal Medicine, Cardiovascular Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. a841120@ms3.hinet.net
authors.forename: Shih-Hung
authors.initials: SH
authors.lastname: Hsiao
authors.forename: Wen-Chin
authors.initials: WC
authors.lastname: Wang
authors.forename: Shu-Hsin
authors.initials: SH
authors.lastname: Yang
authors.forename: Chiu-Yen
authors.initials: CY
authors.lastname: Lee
authors.forename: Shu-Mei
authors.initials: SM
authors.lastname: Chang
authors.forename: Shih-Kai
authors.initials: SK
authors.lastname: Lin
authors.forename: Kuan-Rau
authors.initials: KR
authors.lastname: Chiou
mesh_terms: D000328:Adult; D002306:Cardiac Volume / Q000502:physiology*; D016022:Case-Control Studies; D003971:Diastole / Q000502:physiology; D018619:Echocardiography, Doppler, Pulsed; D005260:Female; D006344:Heart Septal Defects, Atrial / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology; D008297:Male; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D017725:Ventricular Pressure / Q000502:physiology*