Clinical Application of Tissue Doppler Imaging in Patients With Idiopathic Pulmonary Hypertension

摘要

Background: Tissue Doppler (TD) echocardiographic imaging of mitral and tricuspid annulus hasnbeen applied to assess right ventricular (RV) and left ventricular (LV) function in many cardiacndiseases, but its clinical application, including response to long-term targeted therapy in patientsnwith idiopathic pulmonary hypertension (PH), has not been addressed.nMethods: Seventy patients with idiopathic PH were compared with 35 age-matched controlnsubjects to examine myocardial velocities by TD. Of these, 35 patients underwent repeat imagingnafter long-term targeted therapy. In addition, 50 consecutive patients with idiopathic PH withnsimultaneous right-heart catheterization and echocardiography were examined.nResults: No significant differences were noted between PH patients and the control group innlateral mitral annulus systolic velocity and early diastolic velocity (Ea) by TD, but septal velocitiesnwere significantly lower (p < 0.01). With targeted therapy, myocardial velocities at the septumnand RV free wall increased significantly (p < 0.05). Likewise, E/Ea ratio increased, albeit still innthe normal range. In all 50 patients with invasive measurements, lateral E/Ea ratio readilynidentified normal mean pulmonary capillary wedge pressure (PCWP).nConclusions: TD imaging of the lateral mitral annulus can reliably predict the presence ofnnormal/reduced mean PCWP in patients with idiopathic PH, and track the improvement in RVnfunction and LV filling with long-term targeted therapy.