Right Ventricular Function In Patients Research Articles

Прогностическое значение функции правого желудочка у больных ХСН

Прогностическое значение функции правого желудочка у больных ХСН

Analysis of Right Ventricular Function in Patients with Hypothyroidism

Analysis of Right Ventricular Function in Patients with Hypothyroidism

Relation of right ventricular dysfunction to the severity of hepatic cirrhosis by different echo modalities using speckle-tracking echocardiography

Background Speckle-tracking echocardiographic (STE) studies have shown the presence of right ventricular (RV) dysfunction before the advent of RV failure in patients with hepatic cirrhosis. We aimed to evaluate RV function in patients with hepatic cirrhosis and assess the relation of RV dysfunction to the severity of hepatic cirrhosis using different echo-Doppler modalities including STE. Patients and methods This study included 49 patients with various degrees of hepatic cirrhosis and 34 healthy normal individuals (NL). Patients were classified into group A (11 patients), group B (17 patients), and group C (21 patients) according to disease severity using the Child–Pugh score. Conventional echo-Doppler parameters of RV function together with tissue Doppler imaging-derived RV strain and speckle-tracking echo-derived right ventricular global strain (STE-RVGST) were obtained.

Right ventricular function in patients with heart failure in a cardiac clinic in Southwest Nigeria.

Background:Right ventricular (RV) function is an important entity in heart failure. Patients with RV dysfunction (RVD) have poorer prognosis and exercise tolerance than those with preserved RV systolic function. Tricuspid annular plane systolic excursion (TAPSE) has been proposed as a simple and reproducible parameter for the qualitative assessment of RV systolic function/ejection fraction (EF). This study aims at describing RV function/RVD among heart failure patients in a specialized cardiac facility in Southwestern Nigeria.Materials and Methods:One hundred and thirty-two patients with clinical diagnosis of heart failure were recruited into the study between June 2011 and December 2014. Baseline data, laboratory investigations, electrocardiography, and echocardiography were taken for the participants. RV function was assessed with TAPSE. Statistical analysis was done using Statistical Package for Social Sciences 16.0 (Chicago Ill. USA). P < 0.05 was considered statistically significant.Results:The mean age of study participants was 62.1 ± 14.2 years. RV systolic dysfunction (TAPSE <20 mm) was found in 86 (65.2%) of all patients while moderate-to-severe RVD (TAPSE <15 mm) was found in 26 (19.7%) patients. Those with RVD are more likely to be older and had a larger left ventricular internal diastolic dimension than those without RVD. Systolic blood pressure, diastolic blood pressure, and EF were significantly lower among patients with RVD than those with normal RV function.Conclusion:RVD is common and is associated with more advanced heart failure and possibly worse prognosis among Nigerians with heart failure. Screening for RVD is encouraged to identify and aggressively treat to reduce the associated increased mortality.

ECG-gated pulmonary artery CTA for evaluation of right ventricular function in patients with acute pulmonary embolism.

To evaluate right ventricular function in patients with acute pulmonary embolism (APE) using electrocardiogram-gated CTA and to discuss the clinical value of pulmonary artery CTA PATIENTS AND METHODS: Based on death risk evaluation, 86 APE patients were divided into high-risk group (n=46) and non-high-risk group (n=40). The CT pulmonary embolism (PE) index and parameters of right ventricular function were analyzed from the CTPA images and compared between the two groups. Potential correlation between the two was also discussed. CT PE index (median 24.69%) of the high-risk group was obviously higher than that of the non-high-risk group (median 8.58%) (P<.05). Except the diameter of superior vena cava, all other parameters of right ventricular function were significantly different between the two groups (P<.05). CT PE index was correlated with the parameters of right ventricular function. ECG-gated pulmonary artery CTA is suitable for assessing the severity of APE and right ventricular function.

P1270Effects of blood pressure variability on layer-specific longitudinal strain in hypertensionP1271 Left atrial dynamics and diastolic function in hypertensive patientsP1272Echocardiographic evaluation of right ventricular function in patients with chronic obstructive pulmonary disease in comparison with healthy groupP1273The impact of preeclampsia on myocardial recovery in women with peripartum cardiomyopahty - speckle tracking studyP1274Diagnostic accuracy of bedside lung ultrasonography in emergency (BLUE)

Our previous study showed sub-epicardial longitudinal strain (EpiLS) was an independent prognostic factor for worse outcome in regular treated hypertension but not global longitudinal strain (GLS) and sub-endocardial longitudinal strain (EndLS). Increased blood pressure variability (BPV) has been found associated with target organ damage in hypertension. However, effects of BPV on layer-specific longitudinal strain have not been well studied. The aim of this study was to investigate the effects of different blood pressure parameters on layer-specific longitudinal strain in hypertension. This study included 95 patients (57 men, age 65 ± 12 years) with uncomplicated hypertension who have been regularly treated for more than 1 year. Speckle tracking echocardiography was used for measurement of longitudinal deformation from 3 apical views of left ventricle. GLS was measured by automated function imaging (AFI). We further divided into sub-endocardial and sub-epicardial myocardium and measured their longitudinal strain by manual click-and-draw method and averaged from 3 apical views. Blood pressure parameters included office systolic blood pressure (SBP), office diastolic blood pressure (DBP), central SBP and DBP by tonometry, average 24-hour SBP and DBP, and BPV parameters by ambulatory blood pressure monitor. BPV parameters included standard deviation of daytime SBP (DSSD), standard deviation of nighttime SBP (NSSD), standard deviation of daytime DBP (DDSD), and standard deviation of nighttime DBP (NDSD). We divided subjects into low and high group according to median level of each strain. No blood pressure parameters were different between low and high EndLS group except week difference in NDSD (9.0 ± 3.4 vs. 7.8 ± 2.0 mmHg, p = 0.051). NSSD (11.2 ± 4.6 vs. 9.3 ± 2.9 mmHg, p = 0.027) and NDSD (9.1 ± 3.4 vs. 7.7 ± 2.0 mmHg, p = 0.031) were significant increased in low GLS group but not other parameters. DDSD (10.3 ± 3.0 vs. 9.0 ± 2.5 mmHg, p = 0.034), NSSD (11.4 ± 4.4 vs. 9.1 ± 3.1 mmHg, p = 0.006), and NDSD (9.2 ± 3.2 vs. 7.6 ± 2.2 mmHg, p = 0.012) were significantly increased in low EpiLS group. Only BPV parameters were associated with decreased longitudinal strain in hypertension. Effects of BPV were majorly noted in EpiLS.

A Comparative Study of Rv Function in Anterior And Inferior Stemi

I. Introduction The prognosis of patients with acute myocardial infarction (AMI) is directly related to left ventricular (LV) function and size 1.2 Traditionally, the principal investigated target of clinicians is LV function, with little interest in the right ventricle.However, right ventricular (RV) dysfunction after AMI is also associated with increased risk of morbidity and mortality. 3-5 RV dysfunction has been associated with increased morbidity and mortality in patients with congenital heart disease, valvular disease, coronary artery disease, pulmonary hypertension, and heart failure. 6-8 Right Ventricle (RV) dysfunction may be primarily attributed to abnormality of RV myocardium or secondary to left ventricle (LV) dysfunction, as a consequence of Ventricular Interdependence between the two ventricles, as they are encircled by common muscle fibres, share a common septal wall and are enclosed within a common pericardium. 9 Early recognization of RV dysfunction is warranted but till today it remains a challenging task because of complex structure and asymmetric shape of RV. 10 Most of the previous studies have evaluated RV functions in patients of inferior myocardial infarction. There are only few studies available in literature evaluating RV function in anterior myocardial infarction. Therefore, in the present study conventional echocardiography combined with tricuspid annular plane systolic excursion [TAPSE Fractional area change(FAC), pulsed doppler and TDI were used to evaluate the effect of different infarction sites on RV functional changes in patients with first acute ST-elevation myocardial infarction (STEMI) without concomitant RV infarction.

Tricuspid annular plane systolic excursion inaccuracy to assess right ventricular function in patients with previous tricuspid annulopasty

ObjetivesThe clinical and prognostic usefulness of tricuspid annular plane systolic excursion (TAPSE) is well established. However, the ability of TAPSE to assess right ventricular (RV) function in patients with previous tricuspid valve annulopasty is controversial. This study examined the TAPSE suitability in patients with previous tricuspid valve annuloplasty using right ventricular fractional area change (RVFAC) as reference method. MethodsWe retrospectively analyzed 53 patients who underwent tricuspid valve annuloplasty at our hospital between 2013 and 2016. TAPSE and RVFAC were obtained in preoperative and postoperative periods using standard methodology. ResultsMean age was 68±12years and 34 patients (64.1%) were women. TAPSE decreased significantly after surgery in comparison with pre-surgical values (17±4.2 Vs 12.9±4.1mm, p<0.001). On the contrary, RVFAC did not change significantly after surgery (37±9.2 Vs 36.2.9, p=0.25). The correlation between RVFAC and TAPSE was better in the preoperative (r=0.63, p<0.0001) than in the postoperative period (r=0.38, P=0.005). Good intra- and interobserver agreement for TAPSE and RVFAC was obtained, with intraclass correlation coefficients of 0.97 and 0.92 for TAPSE; and 0.90 and 0.85 for RVFAC, respectively. ConclusionsThese findings suggest that TAPSE is not suitable after tricuspid valve annuloplasty and it leads to an underestimation of RV systolic function. It seems to be appropriate to rely on echocardiographic parameters of global RV function such as RVFAC in this context.

Echocardiographic analysis of left and right ventricular function in patients after mitral valve reconstruction

Echocardiographic analysis of left and right ventricular function in patients after mitral valve reconstruction

Effects of long-term iloprost treatment on right ventricular function in patients with Eisenmenger syndrome

BackgroundRight ventricular (RV) function is an important prognostic factor of pulmonary arterial hypertension (PAH), but there is insufficient data regarding RV function after long-term inhaled iloprost treatment. We evaluated the effect of long-term iloprost treatment on RV function in patients with Eisenmenger syndrome (ES). MethodsEleven consecutive patients with ES associated with congenital heart disease underwent echocardiographic measurements at baseline and 48 weeks after iloprost therapy. In addition, we recorded World Health Organization (WHO) functional class, 6-minute walk distance (6MWD), systemic arterial oxygen saturation (SaO2), and laboratory values such as hemoglobin, serum creatinine, and N-terminal pro-B natriuretic peptide. ResultsAfter 48 weeks of iloprost therapy, mean pulmonary arterial pressure (mPAP), pulmonary arterial systolic pressure (PASP), and pulmonary vascular resistance (PVR) were significantly decreased [mPAP, 42.5 (38.5–61.0) to 36.5 (29.1–40.0)mmHg; PASP, 92.6±19.9 to 74.5±23.8mmHg; PVR, 23.4 (19.8–26.0) to 23.4 (19.8–26.0)Wood unit respectively, all p<0.05]. There was also significant improvement in RV myocardial performance index [0.68 (0.61–0.80) to 0.52 (0.51–0.62), p=0.003] and RV longitudinal strain (−15.7±1.6 to −18.1±1.5%, p<0.001). In clinical assessment, WHO functional class (p=0.006), 6MWD (310.6±44.7 to 399.7±80.8m, p<0.001), and SaO2 (90.9±6.0% to 92.5±6.0%, p=0.022) were significantly improved. ConclusionThe improvement in echocardiographic parameters of the RV function after 48 weeks of iloprost therapy may provide insight on the efficacy of long-term iloprost treatment for RV functional improvement, which is a prognostic factor in patients with ES.

Assessment of RV function following Percutaneous Transvenous Mitral Commissurotomy (PTMC) for rheumatic mitral stenosis

Objective: Abnormal right ventricular function plays an important role in development of clinical symptoms and overall prognosis of patients with mitral stenosis. Hemodynamic and radionuclide studies have demonstrated long-term improvement in RV function after PTMC. However, exact quantification by conventional echocardiographic technique is difficult owing to complex 2D anatomy. This study evaluates the immediate and short term follow up impact of successful percutaneous transvenous mitral valve commissurotomy (PTMC) on RV function in patients with mitral stenosis using 2D Echo and Doppler tissue imaging. Methods: 219 patients (mean age 26 + 6yrs) with rheumatic MS, all in sinus rhythm were studied before and 24-48 hrs after PTMC. Parameters of global and longitudinal RV function were assessed by conventional 2D ECHO and Doppler tissue imaging. Results: Immediately following PTMC, mitral valve area increased from baseline of 0.71 ± 0.15 cm 2 to 1.84 ± 0.17 cm 2 (P 0.0001), RV outflow tract fractional shortening (RVOT–FS) increased from 33.94 ± 7.55% to 37.33 ± 7.67% ( Conclusion: Long term evaluation of RV function and benefits using invasive and radionuclide methods post PTMC has shown incongruous results in improvement of right ventricular (RV) function immediately after PTMC. In this study, immediately after successful PTMC significant improvement in parameters of infundibular and global RV function as assessed by RVOT fractional shortening , Tei index and tissue Doppler velocities was observed. Key words: PTMC, RV function, ECHO indices-2D and DTI, procedural outcome-immediate and short term.

Right Ventricular Function in Patients With Left Ventricular Assist Device Support by Pulsatile Polvad MEV and Continuous-Flow Pumps Heartware and Heartmate II

BackgroundLeft ventricular assist device (LVAD) support is increasingly used in patients with heart failure. The right ventricle (RV) plays a main role in LVAD support. Little is known about the effects of pulsatile Polvad MEV devices or continuouseconds flow pumps on RV function. We compared hemodynamic parameters of RV in patients after implantation of Polvad MEV (PM) and Heartware (HW) or Heartmate II (HMII) LVADs. MethodsForty-four patients were retrospectively reviewed after implantation of PM (group P; n = 24 [21 M, 3 F]) or HW or HMII (group C; n = 20 [20 M, 0 F]) LVADs from April 2007 to February 2014. Hemodynamic data—mean pulmonary pressure (mPAP), central venous pressure (CVP), cardiac output (CO), and cardiac index (CI)—were collected before surgery, after surgery, and every 2 hours in the intensive care unit, with the time points numbered from 1 to 120. Right ventricular work (RVW) was calculated according to the equation: RCW = CO × (mPAP − CVP) × 0.0144 (g·m). ResultsBaseline characteristic of the patients were similar. mPAP values were similar between groups. CVP values were higher in group P, significantly at time points 5 and 7–33. CO values were higher in group C, significantly from point 3 and almost all the time to point 43. CI reached significance at point 9, 12–14, 16–19, and 30–41. RCW was higher in group P before implantation. Post-implantation RCW values were higher in group C, significantly at time points 19, 20, 32–34, 51–53, and 55–57. ConclusionsContinuous-flow pumps more effectively optimize RV function than pulsatile LVADs, which can result in more effective prevention of RV failure or insuffiency in that group.

OP-075 The Evaluation of the Relationship between Pulmonary Artery Stiffness and Right Ventricular Functions in Patients with Behcet’s Disease

OP-075 The Evaluation of the Relationship between Pulmonary Artery Stiffness and Right Ventricular Functions in Patients with Behcet’s Disease

PT125 Comparison of Conventional Measures to Estimate Right Ventricular Function in Patients After Heart Transplantation Using 3D and Speckle-Tracking Echocardiography

PT125 Comparison of Conventional Measures to Estimate Right Ventricular Function in Patients After Heart Transplantation Using 3D and Speckle-Tracking Echocardiography

A clinical study on tricuspid annular displacement predicting the right ventricular function of pulmonary hypertension measured by two-dimensional speckle tracking echocardiography

Objective To measure tricuspid annular displacement by two-dimensional speckle tracking echocardiography in pulmonary hypertension (PH) patients, and compare with the right ventricular function parameters, finally discuss the clinical application value of this technology in evaluating the right ventricular function in PH. Methods A total of 58 patients diagnosed or suspected diagnosed as PH were divided into PH group and control group according to pulmonary arterial systolic pressure measured by echocardiography. The right ventricular function parameters included: tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (FAC), tissue Doppler-derived tricuspid lateral annular systolic velocity (s') and right ventricular index of myocardial performance (RIMP). The parameters of tricuspid annular displacement included: the peak systolic tricuspid annular displacement at right ventricular free wall (TMAD1), the peak systolic tricuspid annular displacement at interventricular septum (TMAD2), the peak systolic tricuspid annular displacement at midpoint of tricuspid annulus (TMADm) and the right ventricular longitudinal shortening (TMADm%). Results ① There were significant statistical differences between two groups in TAPSE, RIMP, FAC and s' (P 0.54 and s'<9.5 cm/s, their sensitivities were 81.8%, 84.4%, 85.7% and 72.3% respectively, and their specificities were 72.0%, 73.1%, 70.3% and 100% respectively. Conclusions The tricuspid annular tissue displacement parameters can predict the decrease of right ventricular function in patients with PH, and provide a new diagnostic index for clinical treatment and prognosis. Key words: Echocardiography; Pulmonary hypertension; Tissue motion annular displacement; Ventricular function, right; Speckle tracking imaging

Bone Morphogenetic Protein Receptor Type 2 Mutation in Pulmonary Arterial Hypertension: A View on the Right Ventricle.

The effect of a mutation in the bone morphogenetic protein receptor 2 (BMPR2) gene on right ventricular (RV) pressure overload in patients with pulmonary arterial hypertension is unknown. Therefore, we investigated RV function in patients who have pulmonary arterial hypertension with and without the BMPR2 mutation by combining in vivo measurements with molecular and histological analysis of human RV and left ventricular tissue. In total, 95 patients with idiopathic or familial pulmonary arterial hypertension were genetically screened for the presence of a BMPR2 mutation: 28 patients had a BMPR2 mutation, and 67 patients did not have a BMPR2 mutation. In vivo measurements were assessed using right heart catheterization and cardiac MRI. Despite a similar mean pulmonary artery pressure (noncarriers 54±15 versus mutation carriers 55±9 mm Hg) and pulmonary vascular resistance (755 [483-1043] versus 931 [624-1311] dynes·s(-1)·cm(-5)), mutation carriers presented with a more severely compromised RV function (RV ejection fraction: 37.6±12.8% versus 29.0±9%: P<0.05; cardiac index 2.7±0.9 versus 2.2±0.4 L·min(-1)·m(-2)). Differences continued to exist after treatment. To investigate the role of transforming growth factor β and bone morphogenetic protein receptor II signaling, human RV and left ventricular tissue were studied in controls (n=6), mutation carriers (n=5), and noncarriers (n=11). However, transforming growth factor β and bone morphogenetic protein receptor II signaling, and hypertrophy, apoptosis, fibrosis, capillary density, inflammation, and cardiac metabolism, as well, were similar between mutation carriers and noncarriers. Despite a similar afterload, RV function is more severely affected in mutation carriers than in noncarriers. However, these differences cannot be explained by a differential transforming growth factor β, bone morphogenetic protein receptor II signaling, or cardiac adaptation.

Maladaptive aortic properties after the Norwood procedure: An angiographic analysis of the Pediatric Heart Network Single Ventricle Reconstruction Trial

ObjectivesAortic arch reconstruction in children with single ventricle lesions may predispose to circulatory inefficiency and maladaptive physiology leading to increased myocardial workload. We sought to describe neoaortic anatomy and physiology, risk factors for abnormalities, and impact on right ventricular function in patients with single right ventricle lesions after arch reconstruction. MethodsPrestage II aortic angiograms from the Pediatric Heart Network Single Ventricle Reconstruction trial were analyzed to define arch geometry (Romanesque [normal], crenel [elongated], or gothic [angular]), indexed neoaortic dimensions, and distensibility. Comparisons were made with 50 single-ventricle controls without prior arch reconstruction. Factors associated with ascending neoaortic dilation, reduced distensibility, and decreased ventricular function on the 14-month echocardiogram were evaluated using univariate and multivariable logistic regression. ResultsInterpretable angiograms were available for 326 of 389 subjects (84%). Compared with controls, study subjects more often demonstrated abnormal arch geometry (67% vs 22%, P < .01) and had increased ascending neoaortic dilation (Z score 3.8 ± 2.2 vs 2.6 ± 2.0, P < .01) and reduced distensibility index (2.2 ± 1.9 vs 8.0 ± 3.8, P < .01). Adjusted odds of neoaortic dilation were increased in subjects with gothic arch geometry (odds ratio [OR], 3.2 vs crenel geometry, P < .01) and a right ventricle-pulmonary artery shunt (OR, 3.4 vs Blalock–Taussig shunt, P < .01) but were decreased in subjects with aortic atresia (OR, 0.7 vs stenosis, P < .01) and those with recoarctation (OR, 0.3 vs no recoarctation, P = .04). No demographic, anatomic, or surgical factors predicted reduced distensibility. Neither dilation nor distensibility predicted reduced right ventricular function. ConclusionsAfter Norwood surgery, the reconstructed neoaorta demonstrates abnormal anatomy and physiology. Further study is needed to evaluate the longer-term impact of these features.

The Impact of Isolated Right Coronary Artery Angioplasty on Right Ventricular Functions in Patients with Unstable Angina Pectoris

*Corresponding author: Yavuzer Koza, Ataturk University, Faculty of Medicine, Department of Cardiology, Erzurum, Turkey Tel: +90-4422318503, E-mail: yavuzerkoza@hotmail.com Percutaneous Coronary Intervention (PCI) has been an integral part of management of coronary artery disease over the past three decades. PCI reduces mortality in ST-segment Elevation Myocardial Infarction (STEMI) and improves cardiovascular outcomes in non-STEMI and unstable angina (1, 2). However, the role of PCI in management of stable coronary artery disease is still debatable (3). Although determined by interaction of a large number of factors, prognosis of patients with myocardial infarction is directly related to Left Ventricular (LV) function and size (4). In clinical practice, the right ventricle has remained a forgotten chamber behind the left ventricle. Likewise, most studies have evaluated the prognostic importance of LV function with little interest in the right ventricle. However, involvement of the right ventricle was significantly associated with increased mortality in patients with acute STEMI treated with primary PCI (5). The study by Nikdoust et al. (6) in a recent issue of the International Cardiovascular Research Journal highlights a significant improvement in Right Ventricular (RV) function, but not LV function, after Right Coronary Artery (RCA) PCI in patients with unstable angina. Echocardiographic measurements were performed in a total of 30 subjects prior to elective PCI. Two months after PCI, echocardiography was repeated and the results were compared to baseline. According to the findings, RV systolic and diastolic functional parameters were significantly improved, but there was no significant correlation between these parameters and LV function. Thus, the authors suggested that revascularization of the RCA might be beneficial for patients suffering from RV failure due to ischemia. The significant improvement in RV, but not LV, function, after right coronary PCI in a relatively small population is interesting. In agreement with this study, previous studies also reported significant improvements in RV function after PCI. However, these studies mainly included STEMI patients with different locations (5). In a study on 133 patients with inferior infarction without concomitant RV infarction who underwent primary PCI, only regional RV ►Implication for health policy/practice/research/medical education: To date, the impact of the percutaneous intervention on left ventricular function has been widely studied, with little interest in the right ventricle. This article highlights the importance of the interdependence of the right and left ventricles and the role of percutaneous coronary intervention in the right ventricular function with regard to different lesion sites after isolated right coronary angioplasty.

Echocardiographic assessment of right ventricular functions in patients with proximal right coronary artery chronic total occlusion.

To assess right ventricular functions by echocardiography in patients with proximal right coronary artery (RCA) CTO and correlating it with clinical and angiographic variables. We studied 60 consecutive patients with CTO of the proximal RCA and no other significant lesions in the left coronary system. Echocardiography was performed in order to measure left ventricular (LV) dimensions, LVEF, RV end diastolic area (RVEDA), RV end systolic area (RVESA), RV fractional area change (RVFAC), tricuspid annular plane systolic excursion (TAPSE), Doppler myocardial performance index (MPI), trans-tricuspid E and A waves, E/A ratio, S', e' and a'. Grades of coronary collaterals was assessed. Doppler MPI showed negative correlation with TAPSE (r=-0.8997, p<0.0001) and RVFAC (r=-0.928, p<0.0001). Positive correlation with trans-tricuspid E/A ratio (r=0.893, p<0.0001) and E/e' ratio (r=0.783, p<0.0001). Patients with no evidence of MI had more well-developed (grade 3) coronary collaterals (83.8 vs. 17.4%). Patients with evidence of MI had lower RVFAC 38.13±5.39 versus 45.08±4.99% (p<0.0001), lower TAPSE 20.17±3.85 versus 25.35±3.46mm (p<0.0001), higher MPI 0.4±0.08 versus 0.31±0.05 (p<0.0001), higher trans-tricuspid E/A ratio 1.79±0.38 versus 1.13±0.36 (p<0.0001) and E/e' ratio 5.23±1.02 versus 3.61±0.88 (p<0.0001). Patients with poorly developed collaterals had lower TAPSE and RVFAC and a higher MPI (p<0.0001 for each). Patients with proximal RCA CTOs and evidence of inferior wall MI have significant impairment of RV functions in addition to poorly developed coronary collaterals. Those with proximal RCA CTOs and well-developed coronary collaterals have better RV functions.

Assessment of right ventricular function in patients with right ventricular overload using real-time three-dimensional echocardiography

Objective To evaluate global and segmental right ventricular (RV) systolic functions in patients with excessive volume or pressure load using real-time three-dimensional echocardiography(RT-3DE). Methods Forty-five patients with RV volume overload, 45 patients with RV pressure overload and 45 healthy subjects were underwent RT-3DE. RV global and segmental (inflow, body, outflow) end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV) and ejection fraction (EF) were analyzed with TomTec software. The correlations between EF with the three-dimensional method and two-dimensional parameters including right ventricle systolic pressure(RVSP) were discussed. Results Global EDV and ESV increased significantly in both patient groups compared with controls (all P 0.05). Compensated increase of SV was found in sixty percent of patients with volume overload but none with pressure overload (P<0.05). Global EF decreased significantly in both of patient groups (all P<0.05), which was more significant patients with pressure overload (P<0.05). Different patterns of the regional dysfunction were found among the different RV segments. No correlation was found between RVSP and global or segmental EF in patients with pressure overload. Conclusions RT-3DE could be used to assess global and segmental RV systolic function in patients with pressure and volume overload. Key words: Echocardiography, real-time three-dimensional; Ventricular function, right; Right ventricular overload