Abstract 11930: Association of Inter- and Intra-Ventricular Dyssynchrony With Right Ventricular Performance in Patients With Pulmonary Hypertension
Background: In pulmonary hypertension (PH) patients, increasing of right ventricular (RV) wall tension due to elevation of pulmonary artery pressure (PAP) leads to prolongation of RV systole, resulting in the intra RV and inter-ventricular dyssynchrony. The aim of this study was to evaluate the association of intra RV and inter-ventricular dyssynchrony with RV performance, and its improvement after adding PH-specific drugs in PH patients.
Methods: The study group consisted of 38 PH patients with Dana Point classification group 1 or 4. Echocardiography was performed at baseline and 8±6 months after adding PH-specific drugs. Intra RV dyssynchrony (RV-Dys) was determined as the standard deviation of time-to-peak longitudinal strain from 6 segments from RV-focused view, and inter-ventricular dyssynchrony (Inter-Dys) was determined as the time difference between averaged three longitudinal peak strains of RV free wall and LV lateral wall using two-dimensional speckle-tracking strain. We assessed tricuspid annular plane systolic excursion (TAPSE) and RV fractional area change (RVFAC) for conventional echocardiographic assessment of RV performance.
Results: RV-Dys and Inter-Dys were correlated with TAPSE (r=0.57, p<0.001 and r=0.37, p=0.043, respectively) and RVFAC (r=0.58, p<0.001 and r=0.42, p=0.011, respectively) at baseline. In addition, RV-Dys and Inter-Dys were also correlated with estimated systolic PAP (r=0.46, p=0.004 and r=0.39, p=0.018, respectively) at baseline. It was noteworthy that RV-Dys and Inter-Dys significantly improved after adding PH-specific drugs from 45.7±25.2ms to 35.4±19.2ms (p=0.01), and from 73.5±50.8ms to 46.8±26.0ms (p=0.006), respectively.
Conclusions: Intra RV and inter-ventricular dyssynchrony was associated with RV performance and RV after load, and improved after treatment in PH patients. These indices could have the potential to allow for noninvasive follow-up of such patients.
- © 2013 by American Heart Association, Inc.