RIGHT VENTRICULAR FUNCTION IN ARTERIAL HYPERTENSION (M-MODE ECHOCG STUDY)

Abstract

Objective: Until recently Researchers underestimated right ventricular (RV) physiological and described it as passive conduit with a little pumping capability which just connects right atrium (RA) with pulmonary artery. Over the last decades, numerous studies have demonstrated the physiological and clinical importance of RV function. Contrary to the LV, the RV has much complex geometry. It consists of an inlet, outlet, and apical trabecular portion which are different structurally and functionally. There is no information about Right ventricular outflow structure and function in patients with Arterial Hypertension (AH). The aim of the research was to study the changes of RV Outflow and Inflow functional parameters in patients with Arterial Hypertension. Design and method: We studied 214 patients AH (male-115, fem-99, mean age 55.6±12.2, mean arterial pressure – systolic 174.1±15.2, diastolic 96.8±11.2). Control group consist from 180 normal persons (male-88, fem-92, mean age 49.7±12.2, mean arterial pressure – systolic 122.1±12.2, diastolic 71.8±10.2). All participants undergone standard EchoCG examination. Two-dimensional echocardiograms of the parasternal short axis view at the level of the aortic root were obtained for the RVOT sizes and fractional shortening (RVOT-FS) values. M-mode recordings of the RVOT were obtained and dimensions were measured at end -diastole and end systole. RV outflow Fractional Shortening (RVoutFS%, calculated with formula (RVoutDiastD-RVoutSystD)/RVoutDiastD%). Results: 12 patients had stage-1 AH, 138- stage 2 and 64 stage 3 AH. In AH group RV wall thickness (4.2±0.9 mm versus 3.5±0.7mm), RV outflow tract systolic and diastolic diameters (32.8±4.8mm and 14.7±3.2mm versus 30.8±4.7 and 13.2±2.8mm) where greater and RVoutFS% (55.1±4.8% versus 58.8±4.3%) Pulmonary flow acceleration time (121.6±17.1versus 132.6±12.2 msec) lesser then in control. On the other hand, there was no difference in TAPSE between the groups. Conclusions: Despite any differences in RV inflow function There are prominent changes in RV outflow tract function and structure in patients with AH. RVoutFS% is a marker of early functional changes of RV in patients with AH