Hypertension and diabetes mellitus: How do they affect the right ventricular functions individually and together?

CONTEXT: The right ventricle (RV) is neglected in clinical practice although the RV function is the primary determinant of prognosis and effort tolerance in many groups of patients. AIM: The effects of type two diabetes mellitus and hypertension solitary and together were studied on right ventricular systolic and diastolic function by echo-Doppler and tissue Doppler echocardiography. SETTINGS AND DESIGN: A cohort of 300 consecutive patients with echocardiographic right ventricular (RV) diastolic dysfunction as determined by Doppler echocardiography were included in this study. METHODS AND MATERIAL: Patients were divided in four groups, patients who were neither diabetic nor hypertensive, hypertensive patients, diabetic patients and those patients suffering from both hypertension and diabetes mellitus. Parameters of right ventricular systolic and diastolic function were compared. STATISTICAL ANALYSIS USED: Analyses were performed with SPSS version 12.0 statistical package (SPSS Inc., Chicago, IL, USA). RESULTS: There was significant statistical difference between the four groups as regards E wave, E/A ratio and deceleration time measured by Doppler echocardiography. By pulsed wave tissue Doppler, S, E' and E/E' showed significant statistical difference between the four groups. All of these parameters were significantly different between the group suffering from both diseases and the group who had neither of them. CONCLUSIONS: The combined effect of both, diabetes mellitus and hypertension on right ventricular function is stronger than the effect of one of them alone.