Chest
Original Research: Pulmonary HypertensionClinical Application of Tissue Doppler Imaging in Patients With Idiopathic Pulmonary Hypertension
Section snippets
Patient Population
Seventy consecutive patients with World Health Organization class III/IV idiopathic PH who underwent transthoracic echocardiography were enrolled. The diagnosis of idiopathic PH was established by standard criteria.7Inclusion criteria included the following: sinus rhythm, adequate echocardiographic images for interpretation, no evidence LV myocardial or valvular disease, and pulmonary artery (PA) systolic pressure ≥ 50 mm Hg. Five patients were excluded because of suboptimal Doppler alignment
RV and LV Structure and Function in Patients With PH
As expected, patients with PH had a significantly larger RV area and LV eccentricity index but a lower RV FAC in comparison with age-matched control subjects (Table 1). RV outflow tract AT and ET were shorter in the PH group with a higher index of PVR. The mitral inflow pattern showed predominant late diastolic flow with an E/A ratio < 1. However, mitral annulus lateral Sa and Ea velocities were similar to those of the control group. While septal E/Ea ratio was significantly higher in patients
Discussion
Novel observations in this study include the ability of TD imaging of the lateral mitral annulus to reliably predict the presence of normal/reduced mean PCWP in patients with idiopathic PH, and to track the improvement in LV filling with long-term targeted therapy. In addition, systolic and diastolic myocardial velocities by TD at the septum and RV free wall readily identify the improvement of RV systolic and diastolic function with therapy.
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The authors have no conflicts of interest to disclose.
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