Assessment of right ventriclar function by tissue Doppler in relation to plasma NT-proBNP concentration in patients with dilated cardiomyopathy

Abstract

Background: Impairment of right ventricular function is a common finding in patients with dilated cardiomyopathy (DCM). The aim of the study was to assess the function of the right ventricle by tissue Doppler imaging (TDI) in relation to NT-proBNP concentration in patients with DCM.
Methods: 29 patients with DCM were studied. Group I (n = 21) constituted of subjects with a NT-proBNP concentration > 500 pg/ml and group II (n = 8) constituted of patients with NT-proBNP < 500 pg/ml. In all patients the TDI parameters for the free-wall of the right ventricle were analysed: velocity of myocardium (VEL), strain (ε) and strain rate (SR).
Results: There were no significant differences between the two groups with respect to clinical characteristics, parameters of global and regional left ventricular systolic function or between indicators of global right ventricular function. In group I the maximal values of e in the apical and medial segments of the right ventricular free wall were significantly lower than in group II (-17 ± 10 vs. -29 ± 7%; p = 0.0168 and -13 ± 6 vs. -25 ± 5%; p = 0.0023 respectively). Moreover, in group I the maximal SR in the apical and medial segments of the right ventricular free wall were significantly lower than in group II (1.56 ± 0.6 ε^-1 vs. -1.071 ± 0.5 ε^-1; p = 0.0358 and -0.99 ± 0.38 ε^-1 vs. -1.55 ± 0.37 ε^-1; p = 0.0044 respectively).
Conclusions: Impairment of right ventricular function is most visible in the apical and medial segments. The maximal values of e and SR for the right ventricle free wall are lower in patients with DCM and NT-proBNP > 500 pg/ml. (Cardiol J 2007; 14: 167-173)