Assesment Of Right Ventricular Function In Hypertensive Patients With Different Left Ventricular Geometry By Velocity Vector Imaging

Objective:To assess the right ventricle function in hypertensive patients with different left ventricular geometry by velocity vector imaging.Materials and Methods:Control group is compose of 30 healthy volunteers whose age and gende is mathched weiht hypertension group.66 hypertension, according to Devereu recommended formula left ventricular mass (LVM) and left wentricular mass index (LVMI), relative ventricular wall thickness(RWT). Acoording to Granau clasification divied in two groups:32 cases of normal left ventricular configuration(LVN) group (LVMI and RWT are in the normal range),and 34 cases of left ventricular remodeling(LVR) group (LVMI and RWT exceeded normal range). Conventional echocardiography measurement left ventricular end-diastolic diameter(LVDD), left ventricular end-systolic diameter(LVDS), left ventricular posterior wall (LVPW), interventricular septum(IVS), left ventricular ejection fraction(LVEF). modified simpson's method for measuring the right ventricular ejection fraction(RVEF),early-and late-diastolic peak velocities (Em and Am),the Em/Am ratio of tricuspid annular motion were detected by plused wave tissue Doppler imaging (PW-TDI). In VVI mode, Acquisition and storage of three cycle two dimensional dynamol gray-scale imaging in apical four chamber view. The quantitative analysis of right ventricular long axis image through using Siemens'company's 2.0 version Syngous workplace workstations. The RV free mid-wall and ventricular were divided into basal,mid,apical segments intall 6 segments for analysis. Longitudinal velocities,strain and strain rate of six segments were analyzed, velocity(V),strain(S) and peak systole myocardial strain rate(SRs) repersented the systolic function. Peak early diastolic myocardial strain rate (SRe),peak advanced diastolic myocardial strain rate (SRa) and SRe/SRa represented the diastolic function.Results:①Diastolic function parameters:SRe,SRa,SRe/SRa were significantly lower in left ventricular normal group than in the normal control group(P ), but systolic function paramenters did not follow the same course, velocity of free mid-wall mid,apical segments and ventricular mid segment were significantly lower in the left ventricualr normal group than in the normal contrlo group, among them, free mid-wall mid segment was lowered (P≤0.Ol). there were no differernt of S,SRs in every segments in left ventricular normal group and the normal control group.②Diastolic function parameters in every segments were siginificantly lower in left ventricular renodeling group than in the normal control group (P≤0.01). Systolic function parameters also did not follow the same course, velocity in every segments of free mid-wall and ventricular mid segment were sinificantly lower in left ventricular renodeling group than in normal contriol group (P≤0.01). while no significant difference in other segments. There were no different of S in every segments in left ventricular remodeling group and the normal control group; SRs in every segments of free mid-wall were lower in left ventricular remodeling group than in normal contriol group, among them, apical segment was lowered (P≤0.01). There were no different of SRs in every segments of ventricular in left ventricular ermodeling group and the normal control group.③Diastolic function parameter SRe in the free nid-wall and ventricular apical segment were significantly lower in left ventricular remodeling group than in left ventricular normal group(P≤0.01). systolic function paramenter SRs in every segments of free mid-wall were lower in left ventricular renodeling group than in left ventricular normal group, among them, apical segment was lowered(P≤0.01).Conclusions:1. Right ventricular diastoli functon has been imparied in patients with hypertension with normal geometric left ventricular, and showed tendency following the aggravation of left rentricular geometric.2. Right ventricular systolic function has been impaired progressively along with the aggravation of hypertension.3. Right ventricular regional diastolic function changed earlier than regional systolic function in patients with hypertension.