Abstract
Background:Right ventricular (RV) function is themain determinant of outcomes in pulmonary hypertension (PHT). However, limited studies have evaluated the role of assessing right ventricular contractile reserve. Methods: Controls (n= 22) and PHT subjects (n= 16) underwent low-dose DSE (peak dose 20mcg/kg/min). Right ventricular function was assessed by TAPSE and tricuspid annular systolic velocity (S′) at baseline and peak dobutamine dose. Eleven PHT subjects underwent cardiopulmonary exercise testing to determine VO2 peak. Results: At rest, PHT subjects demonstrated reduced TAPSE and S′ compared with controls (1.7± 0.4 cm vs. 2.8± 0.4 cm, p 10 cm/s), S′ at peak stress remained depressed compared to controls (18.0± 1.3 cm/s vs. 22.5± 0.8 cm/s, p= 0.007). Of the measured RV parameters, S′ at peak stress correlated bestwith exercise capacity (VO2 peak) (r= 0.8, p= 0.003). Conclusions: Right ventricular contractile reserve is reduced in subjects with PHT, even in those with relatively preserved resting systolic function. RV contractile function under stress correlateswith exercise capacity.
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