The effect of systemic hypertension on right ventricular function: An echocardiographic study

Abstract

Left ventricular structural and functional changes in patients with arterial hypertension are well established. However, the influence of arterial hypertension on right ventricular (rV) remodeling is still being investigated. The aim of the current study was to determinate the rV systolic and diastolic function in uncontrolled hypertensive patients and compare these echocardiographic findings to the results of control subjects. We included 40 patients with uncontrolled hypertension without any associated pathology (group A) and 40 healthy subjects control (group B). Subjects included in both groups were free from diabetes, valvular disease and ischemic heart disease. The 2 groups have a comparable average age and sex-ratio. There was a significant increase in parietal thickness, left atrium diameter, left ventricular mass index in group A. The left ejection fraction was comparable between two groups. The diastolic diameter of the RV, the ejection fraction of the RV, the tricuspid annular plane systolic excursion (TAPSE) and the fractional area change were comparable between the 2 groups. The systolic velocity S’ measured at the level of the annulus tricuspid and the global longitudinal strain rate were significantly lower in hypertensive patients(7 ±2 cm versus 13 ± 2 cm/s, P < 0.01) and (− 13. ± 2.6% versus − 19.1 ± 2% P < 0.01) reflecting subclinical RD systolic dysfunction. In addition, the early (Ea) peak velocity at the tricuspid annulus was significantly lower in group A (6.8 ± 1.9 cm/s versus 12.1 ± 4.1), P < 0.01 with a consequence lower Ea/Aa suggestion a RV relaxation disorder. Our study revealed a RV dysfunction in uncontrolled hypertension patients, Doppler tissue and 2D strain were very powerful in detection of RV abnormalities at an early subclinical stage.