Mild elevation in pulmonary artery systolic pressures resulted in lower peak longitudinal RV free wall strain (-27.3% vs. -31.9%, P<0.04) and significant RV dyssynchrony (-83 ms vs. 1 ms, P<0.00001).
Cross-Sectional (n=40)
Do mild elevations in pulmonary artery systolic pressure affect right ventricular mechanical properties and dyssynchrony?
Mild elevations in pulmonary artery systolic pressure are associated with abnormal right ventricular mechanical properties and dyssynchrony, even before gross abnormalities in RV size or function appear.
Absolute Event Rate: -27.3% vs -31.9%
p-value: p=<0.04
BACKGROUND: Although right ventricular (RV) dyssynchrony has been identified in patients with severe pulmonary hypertension due to significant RV enlargement and compromise in systolic function, a more clinically relevant question pertains to RV mechanical properties in patients with mild elevation in pulmonary artery systolic pressures (PASP). METHODS: Several echocardiographic parameters and peak longitudinal strain were measured in 40 patients and divided into two groups of 20 patients based on their PASP. RESULTS: Group I included 20 individuals (mean age 48 +/- 16 years with a mean PASP of 27 +/- 5 mmHg) and Group II included 20 patients (mean age 63 +/- 14 years with a mean PASP of 49 +/- 7 mmHg.) All time intervals were adjusted for heart rate. RV fractional area change and tricuspid annular plane systolic excursion for Group I (62 +/- 12% and 2.74 +/- 0.56 cm) and Group II (49 +/- 14%; P < 0.02 and 2.09 +/- 0.40; P < 0.002) were both normal. However, Group II had lower peak longitudinal RV free wall (RVF) strain (-27.3 +/- 7.1 % vs. -31.9 +/- 8.7%, P < 0.04), longer time to peak RVF strain (448 +/- 57 ms vs. 411 +/- 43 ms; P < 0.03) and evidence of significant RV dyssynchrony (-83 +/- 55 ms vs. 1 +/- 17 ms, P < 0.00001) in contrast to Group I. CONCLUSION: In conclusion, mild elevations in PASP affect the mechanical properties of the RV and result in RV dyssynchrony despite absence of gross abnormalities in RV size or function.
López‐Candales et al. (Wed,) conducted a cross-sectional in Mild pulmonary hypertension (n=40). Mild elevation in PASP vs. Normal PASP was evaluated on Peak longitudinal RV free wall strain (p=<0.04). Mild elevation in pulmonary artery systolic pressures resulted in lower peak longitudinal RV free wall strain (-27.3% vs. -31.9%, P<0.04) and significant RV dyssynchrony (-83 ms vs. 1 ms, P<0.00001).