title: New annular tissue Doppler markers of pulmonary hypertension.
abstract: BACKGROUND
  Tissue Doppler imaging (TDI) of mitral (MA) and tricuspid annulus (TA) events characterizes systolic and diastolic properties of each respective ventricle. However, the effect of chronic pulmonary hypertension (cPH) on these TDI annular events has not been well described.
  
  
  METHODS
  Measurements of right ventricular (RV) performance with TDI of the lateral mitral and tricuspid annuli, to measure isovolumic contraction (IVC) and systolic (S) signals were recorded from 50 individuals without PH and from 50 patients with cPH. To avoid confounding variables, all patients had normal left ventricular ejection fraction and were in normal sinus rhythm at the time of the examination.
  
  
  RESULTS
  As expected, markers of RV systolic performance were markedly reduced while LV systolic function remained largely unaffected in cPH patients when compared to patients without PH. TDI interrogation of the MA revealed lengthening of the time interval between IVC and systolic signal (70 ± 17 msec) when compared to individuals without PH (43 ± 8 msec; P < 0.0001). In contrast, cPH markedly shortened the time interval between IVC and the TA systolic signal (34 ± 12 msec) when compared to individuals without PH (65 ± 17 msec; P < 0.0001).
  
  
  CONCLUSIONS
  cPH lengthens time interval between the IVC and the MA systolic signal while shortening this same interval when the TA is interrogated with TDI; reflecting the potential influence that cPH exerts in biventricular performance. Whether measuring these intervals be routinely used in the follow-up of cPH patients will require further study.
authors.affiliation: Cardiovascular Institute, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213-2582, USA. lopezcandalesa@upmc.edu
authors.forename: Angel
authors.initials: A
authors.lastname: López-Candales
authors.forename: Kathy
authors.initials: K
authors.lastname: Edelman
authors.forename: Beth
authors.initials: B
authors.lastname: Gulyasy
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Candales
mesh_terms: D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity