Temporal differences in ejection between right and left ventricles in chronic pulmonary hypertension: a pulsed...

Area of Science:

• Cardiology
• Medical Imaging
• Pulmonary Hypertension Research

Background:

• Chronic pulmonary hypertension (cPH) is associated with altered right ventricular (RV) function and mechanical dyssynchrony.
• Sophisticated echocardiographic tools are not universally available, necessitating simpler diagnostic methods.

Purpose of the Study:

• To evaluate the utility of Doppler-derived temporal differences between right ventricular outflow tract (RVOT) and left ventricular outflow tract (LVOT) spectral signals for detecting cPH-induced mechanical dyssynchrony.
• To assess if pulsed Doppler can identify temporal changes in ventricular ejection timing in cPH patients.

Main Methods:

• Pulsed Doppler spectral signals from RVOT and LVOT were analyzed in 30 healthy controls and 40 cPH patients.
• Temporal delay from onset and time to maximum peak ejection between RVOT and LVOT were measured.
• Right ventricular stroke volume index (RVOT VTI) was also assessed.

Main Results:

• Patients with cPH exhibited a significantly longer temporal delay from onset between RVOT and LVOT (23 ± 12 ms vs. 0 ± 0 ms) compared to controls.
• The time to reach maximum peak ejection was significantly shorter in cPH patients (27 ± 24 ms vs. 61 ± 23 ms).
• cPH patients showed a statistically lower RVOT VTI (0.14 ± 0.05 cm vs. 0.17 ± 0.03 cm).

Conclusions:

• Doppler-derived temporal alterations in ventricular ejection onset and peak ejection timing are evident in cPH.
• These findings suggest Doppler can detect RV mechanical dyssynchrony resulting from cPH.
• Further research is needed to establish the prospective utility of these Doppler measurements in cPH patient follow-up and treatment.