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Right ventricular diastolic dysfunction in arterial systemic hypertension: analysis by pulsed tissue Doppler
S Cicala1, M Galderisi, P Caso
1PhD in Medical-Surgical Physiopathology of Cardiopulmunar and Respiratory System and Associated Biotechnologies, Second University of Naples, Italy
Summary
Arterial systemic hypertension is linked to impaired right ventricular diastolic function, specifically prolonged relaxation. This dysfunction is associated with right ventricular hypertrophy and altered passive wall properties.
Area of Science:
- Cardiology
- Echocardiography
- Hypertension Research
Background:
- Arterial systemic hypertension (ASH) is a widespread condition with significant cardiovascular implications.
- Right ventricular (RV) function is crucial for overall cardiac health, yet often overlooked in hypertension studies.
- Pulsed tissue Doppler (PTD) offers detailed insights into myocardial function.
Purpose of the Study:
- To investigate RV longitudinal function in patients with ASH using PTD.
- To assess diastolic dysfunction in the RV of hypertensive individuals.
- To explore the relationship between RV dysfunction and echocardiographic parameters.
Main Methods:
- The study included 30 normotensive and 30 hypertensive individuals without cardiac medication.
- Standard Doppler echocardiography and PTD of the tricuspid and mitral annuli were performed.
- Systolic and diastolic measurements were acquired using PTD.
Main Results:
- Hypertensive patients exhibited increased left ventricular mass and impaired diastolic indices.
- No significant changes in global systolic function were observed in hypertensives.
- PTD revealed a reduced RV E/A ratio and prolonged relaxation time in hypertensives compared to controls (P<0.00001).
Conclusions:
- ASH is associated with RV longitudinal diastolic dysfunction.
- This dysfunction is characterized by prolonged active relaxation, linked to RV hypertrophy.
- Impaired passive wall properties, influenced by left ventricular pressure overload, contribute to diastolic dysfunction.