title: Right ventricular regional systolic function and dyssynchrony in patients with pulmonary hypertension evaluated by three-dimensional echocardiography.
abstract: BACKGROUND
  The aim of this study was to evaluate right ventricular (RV) regional systolic function and dyssynchrony in patients with pulmonary hypertension (PH) using real-time three-dimensional echocardiography.
  
  
  METHODS
  Real-time three-dimensional echocardiographic images were acquired to obtain RV regional (inflow, body, and outflow) ejection fraction (EF) and time to minimum systolic volume in 70 patients with PH and 26 normal controls. Pulmonary artery systolic pressure (PASP) and pulmonary vascular resistance measured by echocardiography in all subjects and by right heart catheterization in 17 patients were recorded.
  
  
  RESULTS
  Inflow EF and global EF were significantly lower in patients with PH than in controls (P < .05). Body EF was significantly decreased in patients with moderate (PASP, 50-69 mm Hg) and severe (PASP ≥ 70 mm Hg) PH (P < .05). Outflow EF was significantly lowered in patients with severe PH (P < .001). The standard deviation of regional time to minimum systolic volume corrected by heart rate was significantly prolonged in patients with severe PH (P < .05). Inflow EF and global EF were negatively correlated with PASP (r = -0.731 and r = -0.769, respectively, P < .001) and with pulmonary vascular resistance (r = -0.789 and r = -0.801, P < .001).
  
  
  CONCLUSIONS
  In patients with PH, RV inflow and global systolic function was impaired in inverse relationship with PASP and pulmonary vascular resistance. RV systolic synchronicity was impaired in patients with severe PH. Evaluation of RV regional systolic function using real-time three-dimensional echocardiography may play a potential role in the noninvasive assessment of the severity of PH.
authors.affiliation: Division of Echocardiography and the Division of Cardiology, Zhongshan Hospital of Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai Institute of Medical Imaging, Shanghai, China.
authors.forename: Dehong
authors.initials: D
authors.lastname: Kong
authors.forename: Xianhong
authors.initials: X
authors.lastname: Shu
authors.forename: Lili
authors.initials: L
authors.lastname: Dong
authors.forename: Cuizhen
authors.initials: C
authors.lastname: Pan
authors.forename: Leilei
authors.initials: L
authors.lastname: Cheng
authors.forename: Haohua
authors.initials: H
authors.lastname: Yao
authors.forename: Daxin
authors.initials: D
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D015203:Reproducibility of Results; D013599:Systole; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000503:physiopathology*