NONINVASIVE MEASUREMENT OF RIGHT VENTRICULAR FUNCTION IN PULMONARY HYPERTENSION – STUDY FROM A TERTIARY CARE CENTRE IN GUJARAT

Abstract

OBJECTIVES:  Pulmonary hypertension (PH) is the disease of pulmonary circulation with consequent impact on right ventricular (RV) function. 2D Echocardiography is an easily available noninvasive method for PH detection. RV bears the major brunt of PH. We aim to analyse RV function with reference to PH severity by 2D Echocardiography and tissue Doppler imaging.

METHODS: 60 patients with PH defined as 2D echocardiographic RV systolic pressure (RVSP) of >=40 mm Hg were recruited prospectively. Various 2D Echoacardiographic parameters were analysed. RV ejection fraction (RVEF) was calculated by volumetric assessment by method of disc. Tissue Doppler imaging was performed to measure tricuspid annular systolic excursion (TASE). RVEF less than 35% and TASE less than 0.100 m/s were considered as abnormal RV function. Correlation coefficients (r) were calculated for the relationship between RVSP, a measure of PH severity; and RVEF and TASE, the measures of RV dysfunction.

RESULTS: 51.7% patients had mild PH defined as RVSP between 40-55 mm Hg. There was significant (p<0.0001) negative correlation between RVSP and RVEF with r=-0.5670. There was significant (p<0.001) negative correlation between RVSP and TASE with r=-0.4166. there was significant (p<0.0001) positive correlation between RVEF and TASE with r=0.5821.

CONCLUSION: RVEF and TASE are the markers with significant value in identifying RV dysfunction and in prognosticating a patient with PH; and can be measured by easy, noninvasive and cost effective tool like 2D Echocardiography and Tissue Doppler Imaging.