Evaluation on the ventricular dyssynchrony in patients with pulmonary hypertension using velocity vector imaging / 中华超声影像学杂志

ABSTRACT

Objective To determine whether strain and strain rate derived from velocity vector imaging ( VVI) allowed assessment of regional and global right ventricular ( RV) dysfunction and intra‐and inter‐ventricular dyssynchrony in patients with pulmonary hypertension ( PHTN) . Methods Ninety‐nine patients were enrolled , including 35 controls and 64 PHTN patients . All participants underwent echocardiography examinations and off line strain/strain rate analysis . Bi‐ventricular regional peak systolic strain ,strain rate ,and the time‐to‐peak systolic variables were measured at the RV free wall ,inter‐ventricular septum ,and LV lateral wall in apical four chamber views . Standard deviations of the time‐to‐peak systolic strain (SD‐Ts) and strain rate (SD‐Tsr) at six RV and three left ventricular (LV) segments were calculated to define intra‐and inter‐ventricular dyssynchrony . Results Compared with the controls , segmental and global peak systolic strain and strain rate decreased in the PHTN patients . And intra‐right ventricular dyssynchrony was present in the PHTN patients [SD‐Ts(28 ± 20)ms in controls vs (61 ± 62) ms in patients , P = 0 .003 ] . The difference between the time‐to‐peak systolic strain rate at the basal segment of RV free wall and LV lateral wall indicated earlier RV free wall contraction in PHTN patients , relativetoLVlateralwall,particularlyinthoseseverePHTNpatients[(13±13)msincontrolsvs( -49± 14) ms in patients , P < 0 .01] . Conclusions PHTN impairs RV myocardial contraction and induces to ventricular mechanical dyssynchrony .VVI could monitor RV function during the treatment of PHTN .