The echocardiographic impact of the systemic hypertension on the right ventricular: A Tunisian Cohort

Abstract

Only few echocardiographic data are available in literature concerning the impact of the systemic hypertension on the right ventricle (RV) comparing to the left ventricle's impact. To describe the echocardiographic parameters concerning the impact of the systemic hypertension on the RV. Prospective and comparative study including 100 patients from June 2016 to June 2017, subdivided into two groups: Group A (50 patients, systemic hypertension) and group B (50 healthy patient, a control group). We compared the echocardiography parameters of the RV identified in both groups. The RV diameter, the RV ejection fraction (RVEF) and the right ventricular fractional area change (RV-FAC) were preserved and comparable in both groups. RV wall thickness was more increased in group A. The tricuspid annular plane systolic excursion (TAPSE) were comparable in both groups. TEI index was significantly higher ( P < 0.01) and the peak of systolic tricuspid annular motion velocity was significantly lower ( P < 0.01) in group A, reflecting the subclinical and asymptomatic RV systolic dysfunction. The RV global longitudinal strain (GLS-RV) was significantly lower in patient with hypertension. Tissue-Doppler and 2Dstrain were more reliable then RVEF, RV-FAC and TAPSE to determine a latent RV systolic dysfunction. The peak of Ea wave was significantly lower in group A and the peak of Aa wave was significantly higher in this group. The Ea/Aa ratio was lower in patient with hypertension ( P = 0.001) suggesting a RV diastolic dysfunction. Our study confirms that the impact of the systemic hypertension includes the RV as is well known about the LV. Therefore, the functional and morphological analysis of the RV must be evaluated during the regular echocardiographic follow-up of patients with hypertension to allow an early identification of subclinical systolic and diastolic RV dysfunction in order to revise the current therapeutic strategy.