Right ventricular diastolic function in chronic obstructive lung disease

Abstract

Early detection of diastolic dysfunction in chronic obstructive lung disease (COLD) patients could have great prognostic value. Echocardiography has been shown to be a useful technique in studying left ventricular diastolic function. A noninvasive method of studying right ventricular diastolic function has not yet been reported. Pulsed Doppler echocardiography was used to assess right ventricular diastolic function in three groups of subjects: Group I: 35 COLD patients with pulmonary hypertension; Group II: 32 COLD patients without pulmonary hypertension; and Group III: 18 control subjects. Ratios between peak atrial filling velocity (A) and peak early filling velocity (E) (A/E), deceleration half times of the right ventricular rapid filling wave (DHT), and the interval between pulmonary valve closure and tricuspid valve opening (isovolumic relaxation times) (Pc-To) were significantly different in Group I in comparison to Groups II and III. Sensitivity of A/E ratio and Pc-To were 82 and 77%, respectively, and specificity 90 and 72%, respectively; positive predictive values were 90 and 75%, respectively, and negative predictive value 82 and 74% respectively. The multiple correlation coefficient between A/E, acceleration time (ACT), DHT, Pc-To and mean pulmonary artery pressure was 0.75 for Groups I and II together. In conclusion 2D echo-Doppler proved to be useful in evaluating right ventricular diastolic function in all hypertensive COLD patients, revealing a high correlation between diastolic parameters and mean pulmonary artery pressure in both normotensive and hypertensive COLD patients.