Markers right ventricular diastolic dysfunction in patients with pulmonary hypertension.

Abstract

Objective. To study the indices of the right ventricle filling (RV) in patients with pulmonary chronic pathology with and without pulmonary hypertension (PH). Material and methods. 244 people were examined (181 male; age 63.5 [61,0-71,0] years) The study included patients with pathology of respiratory organs without PH (n = 139), patients with echocardiographic signs of PH (n = 45) and healthy people as a control group (n = 60). At an echocardiography evaluated tricuspid blood flow parameters: peak early diastolic flow velocity (Et), the flow of atrial systole (At), indicators of spectral tissue Doppler of the tricuspid valve ring (e't, a't, e't/a't). We assessed the frequency of detection of RV diastolic dysfunction using the ratio Et/t, ratio Et/e't and the propagation velocity of the tricuspid flow (Vpt). Results. The incidence of the main markers of RV diastolic dysfunction was 18.7% in the control group, 27.8% in the group of patients with pulmonary pathology without symptoms of PH and 35% in patients with PH. Vpt reduction <35 cm/sec, was found in 12.2%, 49.5% and 64.6% of patients, respectively. When used together, the markers incidence of diastolic dysfunction of RV in the control group was 27% in patients without lung pathology PH - 57.6%, and patients with the presence of PH - 75.9%. Conclusion. RV diastolic dysfunction in patients with pulmonary pathology manifests itself not only the deterioration of its main markers, but to a greater degree to reduce the spread of its filling flow rate. With the development of PH noted a further decline of this indicator. The combined use of key indicators and the propagation velocity of the tricuspid flow can improve the detection of RV diastolic dysfunction in diseases of the lungs before the development of PH.