| Objective To investigate the correlation between pulmonary arterial stiffness(PAS)and right heart catheterization in patients with moderate and severe pulmonary hypertension(PH).To investigate the correlation between PAS and right ventricular function parameters in patients with moderate and severe PH.Methods Twenty-nine patients with moderate to severe PH diagnosed by right heart catheterization in the General Hospital of Ningxia Medical University from October 2021 to February 2023 were enrolled.According to the World Health Organization(WHO)conference on PH,they were divided into the moderate PH group(36mm Hg < m PAP ≤ 45 mm Hg)in 14 cases,severe PH group(m PAP > 45 mm Hg)in 15 cases,Twenty-two healthy normal people in the same period were included as the control group,The general clinical data of all patients were collected,and two-dimensional speckle tracking imaging and conventional echocardiography were performed on all subjects.The general clinical data,PAS-related parameters,conventional echocardiography parameters,and overall and segmental strain parameters of two-dimensional speckle tracking imaging were compared among the three groups.Then,the correlation between the PAS index and right heart catheterization in patients with moderate or severe PH,the correlation between the PAS index and conventional echocardiographic right ventricular function parameters,the global and segmental strain parameters of two-dimensional speckle tracking imaging in patients with moderate and severe PH were analyzed.Results1.There was no significant difference in age,weight,height,heart rate,BMI,systolic blood pressure,and diastolic blood pressure among the three groups(P > 0.05).2.Comparison of PAS-related parameters measured by echocardiography among the three groups: compared with the control group,the moderate PH group and the severe PH group had lower PAT and higher PAS(P < 0.05).Compared with the moderate PH group,the severe PH group had a lower PAT and a higher PAS(P < 0.05).3.Comparison of right heart catheterization values between the moderate PH group and severe PH group: PASP,PADP,m PAP,RVDP,RVSP,and mRVP were increased in the severe PH group compared with the moderate PH group,and the difference was statistically significant(P <0.05).4.The correlation analysis between PAS and right heart catheterization in moderate and severe PH groups showed that PAS was positively correlated with PASP,PADP,m PAP,RVSP,RVDP,and mRVP(r/ρ= 0.619,0.667,0.773,0.404,0.438,0.481,all P < 0.05).5.Comparison of conventional ultrasound parameters among the three groups: MPA,RV-B,RV-M,RV-L,RA-D1,RA-D2,RVFWT,and IVC in the moderate PH group was significantly higher than those in the control group(P < 0.05);RVFWT,RV-B,RV-M,RV-L,RA-D1,RA-D2,RVOT Prox,MPA,and IVC were increased in the severe PH group compared with the control group(P < 0.05).There were significant differences between the moderate PH group and the severe PH group in RVFWT,RA-D1,RA-D2,RVOT Prox,MPA,and IVC(P <0.05).6.Comparison of right ventricular systolic function parameters assessed by echocardiography in the three study groups: compared with the control group,RIMP was increased and FAC,S’,and TAPSE were decreased in the moderate PH and severe PH groups,with statistically significant differences(P < 0.05).compared with the moderate PH group,RIMP was increased and S’ was decreased in the severe PH group,with statistically significant differences(P < 0.05).7.Comparison of right ventricular diastolic function parameters assessed by echocardiography in the three study groups: E/E’ and A were increased and E/A and E’ were decreased in the moderate PH and severe PH groups compared with the control group,with statistically significant differences(P < 0.05).E/E’ and A were increased and E/A and E’ were decreased in the severe PH group compared with the moderate PH group,with statistically significant differences(P < 0.05).8.The global and segmental peak longitudinal strain parameters of the right ventricle were compared among the three groups: there were statistically significant differences between the moderate group and the severe group concerning RVGLS,RVLS-B,RVLS-M,RVLS-A,RVSLS-B,RVSLS-M,and RVSLS-A(P < 0.05).It was statistically significant that RVGLS,RVLS-B,RVLS-M,RVLS-A,RVSLS-B,RVSLS-M,and RVSLS-A decreased in the severe group compared to the moderate group(P < 0.05).9.The correlation analysis between PAS and right ventricular systolic function parameters in the moderate and severe PH group showed that PAS was positively correlated with RIMP(r/ρ= 0.410,P < 0.05).It was negatively correlated with S’ and TAPSE(r/ρ=-0.671,-0.655,both P < 0.05).There was no significant correlation with FAC(P > 0.05).10.The correlation analysis between PAS and right ventricular diastolic function parameters in the moderate and severe PH group showed that PAS was positively correlated with E/E’(r/ρ= 0.413,P < 0.05).It was negatively correlated with E,E/A,and E’(r/ρ=-0.565,-0.480,-0.621,all P < 0.05).There was no significant correlation with A,A’,E’/A’(all P > 0.05).11.The correlation analysis between PAS and right ventricular global and segmental peak longitudinal strain parameters in the moderate and severe PH groups showed the correlation analysis between PAS and right ventricular function parameters in the PH group.Among them,PAS was negatively correlated with RVGLS,RVLS-B,RVLS-M,RVLS-A,RVSLS-B,RVSLS-M,and RVSLS-A(r/ρ=-0.529,-0.690,-0.664,-0.598,-0.475,-0.554,-0.578,all P < 0.05).Conclusion1.The level of PAS increased in patients with moderate and severe PH.2.There is a positive correlation between PAS and right heart catheterization in PH patients,suggesting that PAS can be used as a new parameter to evaluate pulmonary artery pressure.3.Right ventricular systolic and diastolic function are decreased in patients with moderate and severe PH.4.There is a correlation between the PAS index and right ventricular systolic and diastolic function parameters in PH patients,suggesting that PAS can be used as a new parameter to evaluate right ventricular function. |
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