TISSUE DOPPLER IMAGING IN DETECTION OF RIGHT VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTION IN VARIOUS FORMS OF PULMONARY HYPERTENSION: PP.8.342

Abstract

The Aim: To evaluate the possibilities of Tissue Doppler Imaging (TDI) in detection of early myocardial functional changes in different forms of pulmonary hypertension (PH). Materials and Methods: 29 pts with idiopathic pulmonary hypertension (IPH), 15 pts with chronic thromboembolic disease (CTD), 18 pts with PH, associated with systemic scleroderma (SS), 13 pts with PH, associated with chronic obstructive respiratory disease (CORD),15 pts with PH, associated with congenital heart disease (CHD), 12 pts with residual PH with FC I-III (WHO) and 21 healthy volunteers in control group (CG) were included in the study. Echocardiography, complete conventional and TDI, were operated (Vivid 7, G.E.). Plasma amino-terminal pro-brain natriuretic peptide levels (NT-proBNP) were measured (Elecsys 2010, Roche). Results: IPH and CHD pts were characterized by the most marked heart remodeling accordingly to elevated SPAP (table 1). CORD and RPH pts have the least enlarged right heart chambers and SPAP. Parameters Em RV in CTD and SS pts were rather small while E/Em RV were large and comparable with E/Em RV in IPH pts. Table 1. Echocardiographic parameters and NT-proBNP levels in groups with PH and in controls.We found the higher prevalence of TDI-findings of early RV diastolic dysfunction (DD) as compared with traditional echocardiographic measurements in different forms of PH (89,7% versus 58,6% in IPH, 86,7% vs 46,7% in CTD, 77,8% vs 55,6% in SS, 100% vs 27,3% in CORD, 86,7% vs 26,7% in CHD, 41,7% vs 16,7% in RPH pts). Conclusion: Tissue Doppler Imaging can be a useful tool for detection early features of DD in different forms of PH as compared with traditional echocardiography. CTD and SS pts with moderate systolic echocardiographic parameters and SPAP but high NTpro-BNP levels have marked DD of RV by TDI measuring. Quantity of pts with DD of RV revealed by traditional Doppler measuring was significantly less than detected by TDI in all PH groups.