DIASTOLIC DYSFUNCTION OF THE RIGHT VENTRICLE IN CORONARY HEART DISEASE PATIENTS

Abstract

Aim . Evaluation of the prevalence of the right ventricle diastolic dysfunction (RVDD) in coronary heart disease patients (CHD), and factors associated with its diagnostics. material and methods. Totally, 691 CHD patient included (412 males) at the age 36-85 y.o. (mean age 61,0 y.o.). Patients were selected to 2 groups: with saved diastolic RV function (n=478) and with RVDD (n=199). All participants underwent echocardiography with diastolic function assessment of the left ventricle (LV) and RV in impulse-wave dopplerometry of atrioventricular flows, spectral tissue Doppler of the mitral and tricuspid anuli, and color-M-modal scan. Results. The prevalence of diastolic dysfunction of RV in CHD patients was 29%. Most significant was the decline of velocity of tricuspid flow in group 2, being 22% lower than group 1 (p<0,0001). From the diastolic part of spectrum of tricuspid annulus there was significant decrease of the velocity of its early diastolic motion е t in RVDD t patients by 16% (Z=4,5; p<0,0001). Relation е’ t /а’ t significantly decreased in group 2 (p=0,001). Relation Е t /е’ t increased significantly only in group 2, by 14% (p=0,001). The independent factors associated with RVDD were age (p=0,02), diabetes (p=0,021), clinical picture of angina III functional class (p=0,00011), decrease of LV ejection fraction (p<0,0001) and diastolic dysfunction of LV (LVDD) (p<0,0001 and p=0,0069 with different parameters). Conclusion. RVDD was found in 29% CHD patients, investigated outpatient. With RVDD there was association of age, diabetes, angina III class, decreased LV ejection fraction and LVDD. In RVDD assessment it is purposeful to apply complex approach with the parameters of intraventricular currents.