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Published on: February 3, 2014
Ratio of right to left ventricular ejection: a pilot study using Doppler to detect interventricular dyssynchrony
Angel López-Candales1, Kathy Edelman
1Cardiovascular Institute at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213-2582, USA. lopezcandalesa@upmc.edu
Clinical Cardiology
|May 4, 2011
Summary
Pulsed Doppler measurements can easily detect interventricular dyssynchrony in chronic pulmonary hypertension (cPH) patients. This method identifies differences in right ventricular (RV) and left ventricular (LV) ejection timing, aiding in cPH diagnosis.
Area of Science:
- Cardiology
- Echocardiography
- Pulmonary Hypertension Research
Background:
- Chronic pulmonary hypertension (cPH) causes delayed right ventricular (RV) deformation and mechanical dyssynchrony.
- Previously, RV dyssynchrony was detected using myocardial tissue Doppler imaging.
- Alterations in RV and left ventricular (LV) ejection should be detectable via routine echocardiography.
Purpose of the Study:
- To hypothesize that pulsed Doppler can assess differences in ejection fraction between the left and right ventricles.
- To evaluate the utility of pulsed Doppler in identifying interventricular dyssynchrony in cPH.
Main Methods:
- Collected standard echo and Doppler data from 30 healthy patients and 40 cPH patients.
- Measured temporal differences in RV and LV ejection using the ratio of total duration of RV to LV outflow tract (RVOT and LVOT) pulsed Doppler signals.
Main Results:
- A ratio (<0.99) of RVOT to LVOT total ejection duration effectively identified abnormal pulmonary artery systolic pressure (90% sensitivity, 100% specificity).
- This Doppler ratio also detected interventricular dyssynchrony resulting from cPH.
Conclusions:
- The pulsed Doppler RV to LV ejection duration ratio is easily obtained and useful for identifying interventricular dyssynchrony in cPH.
- Further prospective studies are needed to assess if this ratio can detect subtle changes in ventricular ejection related to disease status or therapy response.