Evaluation of Real-Time Three-Dimensional Echocardiography in Right Ventricular Function and Hemodynamics in Patients with Idiopathic Pulmonary Hypertension

Abstract

Objective: Oriented with the assessment on real-time echocardiography based upon three dimensions (RT-3DE) in estimating right ventricular function and hemodynamics in the patients undergoing idiopathic pulmonary hypertension. Methods: Sixty patients living with idiopathic pulmonary hypertension admitted to our hospital from September 2018 to June 2019 were enrolled. Another 20 healthy examiners were selected as healthy controls. According to pulmonary systolic blood pressure, 60 patients were divided into 20 mild patients, 20 moderate ones as well as 20 severe ones. RT-3DE was used to measure right heart structure related parameters in all subjects, including left ventricular transverse diameter (LVTD), right ventricular transverse diameter (RVTD), right ventricular global end diastolic volume (EDV), right ventricular ejection fraction (RVEF). End-systolic volume (ESV), stroke volume (SV), as well as hemodynamic parameters, including pulmonary systolic pressure (SPAP), right heart output (RCO), pulmonary diastolic blood pressure (DPAP), pulmonary arterial pressure (MPAP). The differences in right heart structure parameters and hemodynamic parameters betwixt the PH Group and the healthy control Group were compared. In addition, conventional two-dimensional echocardiography (2DE) and RT-3DE were used to compare the images of the patients who had serious pulmonary hypertension and those of the Control Group to analyze the tricuspid annulus systolic displacement (TAPSE), the Tei index, and the tricuspid annulus systolic peak velocity (S’) value. The Result is that SPAP, DPAP, and MPAP achieved higher level in the PH Group compared to those in the Healthy Group, and P < 0005, the difference took on statistical significance. Those data of SPAP, DPAP and MPAP in the moderate and severe PH Group were higher than those in the mild PH Group, and P < 0005, the difference was of statistical significance. The RCO of the patients from the PH Group as well as the Healthy Group got under comparison, and P < 0005. They presented statistics-based dramatic difference. In addition, RCO showed a gradual decline in the patients who came down with mild, moderate, and serious PH, and the results were statistically significant. In addition, the comparison between RT-3DE and conventional echocardiography shows that RT-3DE has higher accuracy and diagnostic value.