The Application Of Echocardiography In Assessment Of Right Ventricular Function Among Hypertension Cases

Right ventricular(RV) systolic and diastolic function was evaluated in 44 patients with mild, uncomplicated hypertension using pulsed-wave Doppler echocardiography, 32 normotensive patients without heart disease acted as controlled subjects. We evaluated right ventricular function by measuring the parameters of tricuspid and pulmonary artery blood flow. Tissue Doppler Imagine(DTI) is an ultrasonic technique that can be applied to analyse myocardial motion objectively and quantitatively. With pulsed-wave DTI(PW-DTI) myocardial motion velocity can be measured directly. In this study ,we also analyse mitral and tricuspid annular velocity in early diastole(Ve) and late diastole(Va) in normal and hypertensive patients by DTI, to assess left ventricular(LV)and right ventricular(RV) diastolic function.Main results:l.LV filling parameters were significantly different in the mild hypertensive patients, peak velocity of early filling, ratio of early/late filling velocity and peak filling rate corrected to stroke volume were lower, peak velocity of late filling was higher, and deceleration time was prolonged. RV filling parameters showed similar changes except peak velocity of late filling had no change. LV systolic functional parameters had no change, RV peak velocity and mean acceleration of pulmonary flow were higher, acceleration time was shorter. There are correlations between RV and corresponding LV filling parameters. Pulmonary artery systolic pressure was higher. Right ventricular wall thickness and septal thickness were higher.2.With PW-DTI mitral annular and tricuspid annular motion velocity was measured. In the normotensive patients, tricuspid annular peak early diastolic velocity(Ve), peak late diastolic velocity (Va) and ratio of peak early/late diastolic velocity (e/a) were correlated to age. In the hypertensive patients, only Ve has no correlation with age. The e/a correlated with RV ratio of early/late filling. In thehypertensive patients, tricuspid annular Ve and e/a were lower, Va had no change. Mitral annular motion velocity showed similar changes but peak late diastolic velocity was higher.Conclusion: Pulsed-wave Doppler echocardiography is a simple, correct and practical method in evaluation of right ventricular diastolic and systolic function. Our study shows that right ventricular diastolic function is altered in mild uncomplicated hypertension, and these abnormalities are closely related to those of LV diastolic function. LV systolic function is normal, RV systolic function is stronger. Pulmonary artery systolic pressure (PASP) increased. There is no correlation between systolic blood pressure and PASP, it shows that the increasing of PASP does not rely on that of systolic blood pressure. RV and LV hypertrophy has been shown in uncomplicated hypertensive patients at the same time. PW-DTI can quantify the changes of mitral and tricuspid velocity in hypertensive patient and show the changes of RV and LV diastolic function.