Relationship between Myocardial Right Ventricular Relaxation Time and Pulmonary Artery Pressure in Patients with Pulmonary Arterial Hypertension

Document Type : Original Article

Authors

1 Vascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Akbar Clinical Research and Development Unit, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Recent developments in echocardiography made assessing pulmonary arterial hypertension (PAH) in the heart, a suitable choice. This study aimed to investigate the association of myocardial right ventricular relaxation time and systolic pulmonary artery pressure (SPAP) in PAH patients.
Materials and Methods: The present study evaluated 74 patients with PAH (n=49) and age- and sex-matched healthy controls (n=25). All patients underwent transthoracic echocardiography. We evaluated the right ventricular (RV) function's echocardiographic parameters, including IVRT, IVCT, S, E, A, S’, E’, A’, ET, DT, TAPSE, FAC, and SPAP.
Results: We found no significant differences in age and gender between the two studied groups (p>0.05). However, we observed a significant difference in IVRT, IVCT, E’, A’ (p=0.004), A, S’, DT, TAPSE, FAC and SPSP (p<0.001 for all cases) between two studied groups. Unlike the control group, we revealed a significant correlation between S’ and E’ (r=0.45, p=<0.001), S’ and A’ (r=0.66, p=<0.001), S’ and FAC (r=0.3, p=0.035), A and A’(r=0.4, p=0.004), TAPSE and FAC (r=0.82, p=<0.001), TAPSE and SPAP (r= -0.43, p=0.002), MPI and A (r= -0.35, p=0.013), MPI and ET (r= -0.72, p=<0.001), E/A and E/E’(r=0.47, p=<0.001), and BSA and S’ (r= -0.3, p=0.011). In addition, no meaningful association was found between SPAP and IVRT and IVCT (p>0.05).
Conclusion: Our findings revealed that IVRT and IVCT might not be affected by the SPAP and, therefore, could be used in the assessment of right ventricular function in patients with PAH.

Keywords

References

  1. NANDA NC, GRAMIAK R, ROBINSON TI, SHAH PM. Echocardiographic evaluation of pulmonary hypertension. Circulation. 1974 Sep;50(3):575-81.
  2. Simonneau G, Robbins IM, Beghetti M, Channick RN, Delcroix M, Denton CP, et al. Updated clinical classification of pulmonary hypertension. Journal of the American college of cardiology. 2009 Jun 30;54(1_Supplement_S):S43-54.
  3. Pietra GG, Capron F, Stewart S, Leone O, Humbert M, Robbins IM, et al. Pathologic assessment of vasculopathies in pulmonary hypertension. Journal of the American College of Cardiology. 2004 Jun 16;43(12S):S25-32..
  4. Tuder RM, Archer SL, Dorfmüller P, Erzurum SC, Guignabert C, Michelakis E, et al. Relevant issues in the pathology and pathobiology of pulmonary hypertension. Journal of the American College of Cardiology. 2013 Dec 24;62(25S):D4-12.
  5. RICH S, PIETRA GG, KIERAS K, HART K, BRUNDAGE BH. Primary pulmonary hypertension: radiographic and scintigraphic patterns of histologic subtypes. Annals of internal medicine. 1986 Oct 1;105(4):499-502.
  6. Alimi H, Fazlinezhad A. Two cases of parachute tricuspid valve confirmed by three-dimensional echocardiography. ARYA atherosclerosis. 2017 Mar;13(2):88.
  7. Humbert M, Sitbon O, Chaouat A, Bertocchi M, Habib G, Gressin V, et al. Survival in patients with idiopathic, familial, and anorexigen-associated pulmonary arterial hypertension in the modern management era. Circulation. 2010 Jul 13;122(2):156-63.
  8. Opitz I, Ulrich S. Pulmonary hypertension in chronic obstructive pulmonary disease and emphysema patients: prevalence, therapeutic options and pulmonary circulatory effects of lung volume reduction surgery. Journal of thoracic disease. 2018 Aug;10(Suppl 23):S2763.
  9. Maron BA, Brittain EL, Choudhary G, Gladwin MT. Redefining pulmonary hypertension. The Lancet Respiratory Medicine. 2018 Mar 1;6(3):168-70.
  10. Bigdelu L, Azari A, Mashayekhi Z, Dadgarmoghaddam M, Baradaran Rahimi V. A comparative study on the results of beating and arrested heart isolated tricuspid valve surgery: A cross‐sectional study. Health Science Reports. 2022 Jul;5(4):e702.
  11. 11. Amsallem M, Boulate D, Kooreman Z, Zamanian RT, Fadel G, Schnittger I, et al. Investigating the value of right heart echocardiographic metrics for detection of pulmonary  hypertension     in     patients      with advanced lung disease. The International Journal of Cardiovascular Imaging. 2017 Jun;33:825-35.
  12. Vakilian F, Tavallaie A, Alimi H, Poorzand H, Salehi M. Right atrial strain in the assessment of right heart mechanics in patients with heart failure with reduced ejection fraction. Journal of Cardiovascular Imaging. 2021 Apr;29(2):135.
  13. Sarah B, Ashrith G, Sandeep S. Evaluation, diagnosis, and classification of pulmonary hypertension. Methodist DeBakey cardiovascular journal. 2021;17(2):86.
  14. Melek M, Esen O, Esen AM, Barutcu I, Fidan F, Onrat E, et al. Tissue Doppler evaluation of tricuspid annulus for estimation of pulmonary artery pressure in patients with COPD. Lung. 2006 Jun;184:121-31.
  15. Funk GC, Lang I, Schenk P, Valipour A, Hartl S, Burghuber OC. Left ventricular diastolic dysfunction in patients with COPD in the presence and absence of elevated pulmonary arterial pressure. Chest. 2008 Jun 1;133(6):1354-9.
  16. Al-Baz MS, Ramzy AA, Abd-El Aziz Rezk YE. Usefulness of right ventricular isovolumic relaxation time in predicting systolic pulmonary artery pressure. AAMJ. 2010;8(3).
  17. Acharya V, Rao SM, Seshadri S, Shetty RK. Assessment of Diastolic Dysfunction Parameters and Cardiac Chamber Size in Smokers with COPD: A Case Control Study. Journal of Clinical & Diagnostic Research. 2018 Jan 1;12(1).
  18. Parasuraman S, Walker S, Loudon BL, Gollop ND, Wilson AM, Lowery C, et al. Assessment of pulmonary artery pressure by echocardiography—a comprehensive review. IJC Heart & Vasculature. 2016 Sep 1;12:45-51.
  19. Dambrauskaite V, Delcroix M, Claus P, Herbots L, Palecek T, D’hooge J, et al. The evaluation of pulmonary hypertension using right ventricular myocardial isovolumic relaxation time. Journal of the American Society of Echocardiography. 2005 Nov 1;18(11):1113-20.
  20. Lee JZ, Low SW, Pasha AK, Howe CL, Lee KS, Suryanarayana PG. Comparison of tricuspid annular plane systolic excursion with fractional area change for the evaluation of right ventricular systolic function: a meta-analysis. Open Heart. 2018 Jan 1;5(1):e000667.
  21. DiLorenzo MP, Bhatt SM, Mercer-Rosa L. How best to assess right ventricular function by echocardiography. Cardiology in the Young. 2015 Dec;25(8):1473-81.
Journal of Cardio-Thoracic Medicine
Volume 11, Issue 2
June 2023
Pages 1141-1150

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