title: Tissue Doppler imaging of right ventricular decompensation in pulmonary hypertension.
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.
authors.affiliation: Cardiovascular Institute, University of Pittsburgh, Pittsburgh, PA 15213, USA. simonma@upmc.edu
authors.forename: Marc A
authors.initials: MA
authors.lastname: Simon
authors.forename: Navin
authors.initials: N
authors.lastname: Rajagopalan
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mathier
authors.forename: Sanjeev G
authors.initials: SG
authors.lastname: Shroff
authors.forename: Michael R
authors.initials: MR
authors.lastname: Pinsky
authors.forename: Angel
authors.initials: A
authors.lastname: López-Candales
mesh_terms: D000704:Analysis of Variance; D015150:Echocardiography, Doppler; D005260:Female; D006305:Health Status Indicators; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D013223:Statistics as Topic; D018497:Ventricular Dysfunction, Right / Q000150:complications / Q000000981:diagnostic imaging*; D016277:Ventricular Function, Left