Background There is a well documented association between arterial hypertension and left ventricular diastolic and (in more advanced stages) systolic dysfunction. Conversely, less is known about the influence of hypertension on right ventricular (RV) function. The results of studies in other disease states suggest that tissue Doppler imaging (TDI) may be useful in evaluation of this issue.
Aim The assessment of RV systolic and diastolic function in patients with hypertension.
Material and methods Studied group consisted of 102 hypertensive patients (HT) (mean age 57.8 ± 12.7) without coronary artery disease. 33 healthy age-matched persons served as controls (CG). Each patient underwent echocardiographic study including tissue Doppler imaging of right ventricle and estimation of RV end-diastolic dimension and free wall thickness, peak early and late diastolic tricuspid velocity (E and A, respectively) and right ventricular total ejection isovolume index (Tei). Analysis of tissue velocity curves comprised peak systolic velocity (Sm), peak early diastolic velocity (Em), late diastolic velocity (Am) and isovolumic relaxation time (IRTm) obtained from lateral aspect of the tricuspid annulus.
Results Significantly lower values of Em (p < 0.02), lower Em/Am ratio (p < 0.01) and longer IRTm (p < 0.05) in hypertensive patients than in the controls were indicative of right ventricular diastolic dysfunction. Likewise, Tei index involving both systolic and diastolic function was significantly higher in hypertensive patients reflecting impairment in right ventricular myocardial performance (p < 0.01). Sm which expresses merely systolic function of right ventricle was comparable to that in CG. In forward stepwise multiple regression analysis the only independent predictor of RV Em was Em from the interventricular septum indicating interdependence of the left and right ventricle.
Conclusions The presence of hypertension is associated with the impairment of RV diastolic function as assessed by tissue Doppler echocardiography. TDI seems more feasible method of RV evaluation in clinical settings than conventional echocardiographic approach.