Evaluation of right ventricular function by tissue Doppler strain and strain rate imaging in different grades of pulmonary hypertension

摘要

Background: Tissue Doppler imaging (TDI) of the tricuspidannulus and the longitudinal deformation indices of the right ventricularfree wall are newer methods of evaluation of right ventricle(RV). In this study, we evaluated RV function through the measurementof the TDI of the tricuspid annulus and the deformity indicesof the basal segment of the right ventricular free wall, RV globalstrain, strain rate and their relation with pulmonary artery systolicpressure (PASP), tricuspid annular plane systolic excursion (TAPSE)and right ventricle diameter (RVD) in patients of pulmonary hypertension(PH).Methods: Ninety patients with PH and 90 healthy subjects wereenrolled in this study. The TDI parameters were obtained in thetissue velocity imaging mode during systole (S, S VTI), early relaxation(E), atrial systole (A), The deformation indices included peaksystolic longitudinal strain and strain rate were measured from thebasal segment of the right ventricular free wall and were calculatedas the relative magnitude of segmental deformation.Results: Right ventricle free wall strain, strain rate, S, A and Evelocities, and S VTI were reduced significantly in the PH Group,with a significant negative correlation between S velocity, S VTIwith PASP, and RVD. E velocity has only a negative significant correlationwith RVD and no significant correlation with TAPSE andPASP. There is no significant difference in A velocity and E/A ratiobetween the two groups and these parameters have no significantcorrelation with RVD and TAPSE. In comparison with the H Group,RV longitudinal peak systolic strain and strain rate at the basal segmentof the right ventricular free wall are significantly lower inthe PH Group. Although there are no earlier studies which comparedthese parameters with healthy controls, but the findings arein accordance with studies evaluating PH.Conclusions: There is significant reduction in S, E velocity, andS VTI of the tricuspid annulus. Moreover, the strain/strain rate ofthe basal segment of the right ventricular free wall had a markeddecrease in the PH Group in comparison with the healthy subjects.Large sample size studies with long term follow-up are required todefine the TDI and strain parameters in patients of PH.