Altered synchrony of right ventricular contraction in borderline pulmonary hypertension.
Imaging studies have shown that pulmonary hypertension (PH) is associated with inhomogenous right ventricular (RV) regional contraction, or dyssynchrony, and that this is of prognostic relevance. This study aimed at the identification and functional significance of RV dyssynchrony in borderline PH defined by a mean pulmonary artery pressure between (mPAP) 20 and 25 mmHg. RV dyssynchrony was measured by 2-dimensional speckle tracking echocardiography in 17 patients with pulmonary arterial hypertension (PAH), 13 patients with borderline PH and 14 controls. Dyssynchrony was defined as the R-R interval-corrected standard deviation of the times to peak-systolic strain for the basal and medium segments of the RV. All the PH patients underwent a right heart catheterization. RV dyssynchrony amounted to 69 ± 34 ms in PAH, 47 ± 23 ms in borderline PH and 8 ± 6 ms in controls, all different from each other (p < 0.05). RV dyssynchrony in borderline PH was the only parameter of RV systolic dysfunction in 11 of 13 (85%) of the patients. RV dyssynchrony was accompanied by postsystolic shortening and correlated to RV fractional area change, not to mPAP or pulmonary vascular resistance. RV dyssynchrony occurs in borderline PH and may reflect early RV-arterial uncoupling.
Department of Pulmonology and Respiratory Critical Care, Pulmonary hypertension competence center, Normandie Univ, UNIROUEN, EA 3830, Institute for Research and Innovation in Biomedicine (IRIB), Rouen University Hospital, 76000, Rouen, France. bouchra.lamia@chu-rouen.fr.|Department of Pulmonology, Le Havre Hospital Complexe, BP 84, 76083, Le Havre Cedex, France. bouchra.lamia@chu-rouen.fr.|Department of Cardiology, Le Havre Hospital Complexe, BP 84, 76083, Le Havre Cedex, France. bouchra.lamia@chu-rouen.fr.
Bouchra
B
Lamia
Department of Pulmonology and Respiratory Critical Care, Pulmonary hypertension competence center, Normandie Univ, UNIROUEN, EA 3830, Institute for Research and Innovation in Biomedicine (IRIB), Rouen University Hospital, 76000, Rouen, France.
Jean-François
JF
Muir
Department of Pulmonology and Respiratory Critical Care, Rouen University Hospital, 76000, Rouen, France.
Luis-Carlos
LC
Molano
Department of Pulmonology and Respiratory Critical Care, Rouen University Hospital, 76000, Rouen, France.
Catherine
C
Viacroze
Department of Biostatistics, Normandie Univ, UNIROUEN, Rouen University Hospital, 76000, Rouen, France.
Jacques
J
Benichou
Department of Cardiology, Le Havre Hospital Complexe, BP 84, 76083, Le Havre Cedex, France.
Philippe
P
Bonnet
Department of Pulmonology, Le Havre Hospital Complexe, BP 84, 76083, Le Havre Cedex, France.
Jean
J
Quieffin
Department of Pulmonology and Respiratory Critical Care, Pulmonary hypertension competence center, Normandie Univ, UNIROUEN, EA 3830, Institute for Research and Innovation in Biomedicine (IRIB), Rouen University Hospital, 76000, Rouen, France.
Antoine
A
Cuvelier
Department of Physiology, Faculty of Medicine, Free University of Medicine, Brussels, Belgium.
Robert
R
Naeije
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062186:Arterial Pressure; D006328:Cardiac Catheterization; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D005260:Female; D006339:Heart Rate; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011651:Pulmonary Artery / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014655:Vascular Resistance; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016278:Ventricular Function, Right
Dyssynchrony; Postsystolic shortening; Pulmonary circulation; Pulmonary hypertension; Right ventricle; Speckle tracking echocardiography