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Doppler assessment of right ventricular filling dynamics in systemic hypertension: comparison with left ventricular
1Department of Medicine, Baylor College of Medicine, Houston, TX 77030.
Insights
Systemic hypertension alters right ventricular filling dynamics, impacting how the heart pumps blood. These changes are linked to left ventricular function, not directly to blood pressure or heart structure.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Echocardiography
Background:
- Systemic hypertension is a major cardiovascular risk factor.
- Right ventricular function is crucial for overall cardiac performance.
- Understanding right ventricular filling dynamics in hypertension is essential.
Purpose of the Study:
- To evaluate alterations in right ventricular filling dynamics in untreated hypertensive patients.
- To investigate the relationship between right ventricular filling and left ventricular characteristics.
- To determine correlations between right and left ventricular filling dynamics.
Main Methods:
- Pulsed Doppler echocardiography was used to assess tricuspid and mitral inflow velocities.
- 43 untreated hypertensive patients and 42 normotensive controls were studied.
- Key filling parameters like peak filling rates and fractions were analyzed.
Main Results:
- Hypertensive patients showed higher late to early peak filling velocity ratios and atrial filling fractions.
- Normalized peak filling rate and early filling fractions were reduced in hypertensive patients.
- Right ventricular filling dynamics were strongly correlated with left ventricular filling dynamics.
Conclusions:
- Right ventricular filling dynamics are significantly altered in systemic hypertension.
- These alterations are independent of left ventricular mass or blood pressure.
- Right ventricular filling dynamics remain closely linked to left ventricular filling dynamics.
Abstract:
To assess right ventricular filling dynamics in systemic hypertension, pulsed Doppler echocardiographic studies were obtained at the tricuspid and mitral anuli in 43 untreated hypertensive patients, aged 23 to 66 years, and in 42 age-matched normotensive control subjects. In hypertensive patients, the ratio of late to early peak filling velocity and atrial filling fraction were higher, while normalized peak filling rate, one third and one half filling fractions were lower, compared with control values. Right ventricular filling dynamics correlated poorly with age in hypertensive patients, and were unrelated to left ventricular mass or left ventricular wall thickness. Weak correlations were only found between right ventricular wall thickness and right ventricular peak late inflow velocity, first half and first third filling fractions. However, right ventricular filling dynamics were closely related to left ventricular filling dynamics in both hypertensive patients (r = 0.49 to 0.82) and normal individuals (r = 0.55 to 0.86). Thus right ventricular filling dynamics are altered in hypertension, independently of left ventricular mass or blood pressure, are weakly related to right ventricular thickness, but remain closely correlated to left ventricular filling dynamics.
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