Abstract 11230: Right Ventricular Diastolic Filling Time is an Accurate Parameter to Estimate Pulmonary Pressure: Comparison Echocardiographic Right Ventricular Diastolic Function With Invasive Pulmonary Hemodynamic Variables

Abstract

Introduction and hypothesis: It has been reported that pulmonary hypertension causes right ventricular (RV) dysfunction, but it is unknown the relationship between RV diastolic function and pulmonary pressure. We assessed the hypothesis that RV diastolic function parameters correlated with invasive pulmonary hemodynamics and had utility to estimate pulmonary pressure.

Methods: We enrolled consecutive 138 patients (23 pulmonary artery hypertension, 23 congenital heart disease, 27 pulmonary hypertension owing to left ventricular disease, and 65 controls). We measured the following parameters by pulsed Doppler imaging and tissue Doppler imaging: 1) RV Tei index, RV isovolumetric contraction time (RV-ICT), RV ejection time, RV isovolumetric relaxation time (RV-IRT) and RV diastolic filling time 2) tricuspid inflow velocities E, A, E/A ratio and deceleration time, 3) tricuspid annular velocities: E’, A’ and E’/A’ ratio. Then we compared those parameters with mean pulmonary artery pressure (mPA) measured by right heart catheterization.

Results: RV-Tei index, RV-IRT and RV-filling time had excellent correlations with mPA (RV-Tei index: r=0.71,p<0.0001, RV-IRT: r=0.72, p<0.0001, RV-filling time: r=-0.80, p<0.0001). Multiple regression analysis revealed that RV-filling time was an independent predictor of mPA. When RV-Filling time ratio (RV-filling time/ R-R interval) <0.49 was a predictor of mPA >25mmHg, the sensitivity, the specificity and the accuracy were 92%, 70% and 83%, respectively.

Conclusions: RV diastolic function parameters: RV-filling time, RV-IRT and RV-Tei index correlated with invasive pulmonary hemodynamic variables and RV-filling time was useful to estimate mean pulmonary pressure.