Right ventricular assessment by transthoracic echocardiography in patients with pulmonary hypertension in relation with functional and hemodynamic data

Abstract

Background: Transthoracic echocardiography is a noninvasive method commonly used to assess the right ventricular function in patients with pulmonary hypertension. Aim of study: To determine the role of transthoracic echocardiography parameters (GLSRV, TAPSE, RVs, FAC & RIMP) to assess the right ventricular function in patients with pulmonary hypertension in correlation with functional capacity (six-min walk distance) and trans-catheter mean PAP. Patients and methods: This is a cross sectional study including patients with pulmonary hypertension aged more than18 years at Baghdad Heart Center and Ibn Al-Baitar Heart Center from May 2019 to May 2020. All patients underwent echocardiography examination with estimation of following parameters (LVEF, FAC, TAPSE, RVs, RIMP, PASP, TR velocity, mean PAP, GLSRV) and all patients underwent six-minute walking distance test and Right heart catheterization to assess the functional capacity and pulmonary artery pressure respectively. Results: 40 patients with varied WHO classifications of pulmonary hypertension (mean age 41.58±15.49 years) and male to female ratio were included in the research (1:1.2). GLSRV had a negative linear connection with TAPSE (P=0.015) and RVs` (P=0.017) but not FAC or RIMP. The 6-MWD correlated positively with GLSRV (P = 0.011). Echo and right heart catheterization mean PAP measurements correlated (P value <0.0001). Right heart catheterization severity of pulmonary hypertension correlated with RV function echo parameters like FAC (p=0.020). Conclusion: Global longitudinal strain of right ventricle showed high ability to detect early stage of RV failure in patients with pulmonary hypertension with high agreement of RV failure detection with 6-MWD& echocardiography parameters like RIMP & FAC.