Identifying right ventricular dysfunction with tissue Doppler imaging in pulmonary hypertension

Area of Science:

• Cardiology
• Medical Imaging
• Pulmonary Hypertension Research

Background:

• Standard echocardiography faces challenges in assessing right ventricular (RV) function due to complex RV geometry.
• Tissue Doppler imaging (TDI) offers a potential solution for evaluating RV function.

Purpose of the Study:

• To assess the utility of RV myocardial strain and velocity, measured by TDI, in identifying RV dysfunction in patients with pulmonary hypertension (PH).
• To correlate TDI-derived RV function parameters with invasive hemodynamic measurements in PH patients.

Main Methods:

• A study involving 44 PH patients and 20 healthy controls, measuring RV free wall peak systolic velocity and strain using color TDI.
• Simultaneous right heart catheterization was performed to obtain invasive hemodynamic data.
• TDI measurements were correlated with parameters such as transpulmonary gradient, pulmonary vascular resistance, and cardiac index.

Main Results:

• PH patients exhibited significantly reduced RV free wall velocity and strain compared to controls.
• RV peak strain strongly correlated with transpulmonary gradient (r=0.72) and pulmonary vascular resistance (r=0.73).
• RV strain was also inversely correlated with cardiac index (r=-0.69) and independently associated in a multivariate model.

Conclusions:

• RV myocardial strain, assessed via TDI, is a valuable non-invasive tool for evaluating RV performance in PH.
• RV strain demonstrates a robust correlation with hemodynamic variables critical for assessing RV function in pulmonary hypertension.