IMPACT OF SYSTEMIC ARTERIAL HYPERTENSION ON RIGHT VENTRICULAR FUNCTION ASSISTED BY PULSED TISSUE DOPPLER ECHOCARDIOGRAPHY

Abstract

SUMMARY ypertension is a major cardiovascular risk. Of all known risk factors, hypertension is the most prevalent. Arterial systemic hypertension due to increased overload results in changes in left ventricular remodeling and left ventricular hypertrophy, beside well known impairment of both diastolic and systolic function. Left ventricular hypertrophy is the most powerful risk factor for coronary heart disease, ventricular arrhythmias, congestive heart failure and sudden death. It is well known that many cardiac diseases affect both the left ventricles and the right ventricles; and that left ventricular failure may secondary impair right ventricular diastolic performance, through elevation of the pulmonary artery pressure or ventricular interdependence. This study aimed to determine the effect of hypertension on right ventricular systolic and diastolic function. This study included two groups, group (I) that included 30 healthy individuals, and group (II) that included 60 hypertensive patients, who were divided into another two groups, 1) stage(I) hypertension group whose SBP = 140-159 mmHg or DBP = 90-99 mmHg and 2) stage (II) hypertension H Summary 􀂊 127 group whose SBP > or = 160 mmHg or DBP > or = 100 mmHg. Patients in the study were subjected to full history taking with special emphasis on age, gender and for the diagnosed hypertensive patients, duration of hypertension, duration of treatment and type of treatment were all recorded. Clinical examination to exclude heart and lung disease. 2D echocardiography and Doppler examination were performed, LV dimensions were measured including LVEDD, LVESD, left ventricular ejection fraction, IVS and PWT dimensions, Pulsed-wave Doppler echocardiography was performed for measuring mitral and tricuspid inflow velocity, deceleration time and isovolumetric relaxation time, tissue doppler imaging at the level of RV lateral tricuspid annulus and S, E and A waves were measured. TAPSE of RV, were also assessed. Results of the current study showed that there was no significant difference between the groups regarding age, gender. Regarding LV echo parameters, the comparison between the groups showed no statistically significant difference between them as regards EDD, ESD, EF%. But there was statistically significant difference between the two groups Summary 􀂊 128 regarding interventricular septum and Posterior Wall dimensions (p value <0.05).