Author + information
- Selen Yurdakul1,
- Züleyha Bingöl3,
- Gülfer Okumuş3,
- Şükrü Taylan Şahin2,
- Betül Cengiz2,
- Ayşen Bozkurt2 and
- Saide Aytekin2
Right ventricular (RV) pressure overload influences ventricular interdependence and subsequent left ventricular (LV) geometry. In the present study, we aimed to demonstrate the impact of increased RV pressure on LV systolic deformation and LV twist mechanics in the setting of pulmonary hypertension (PH).
We studied 25 patients with PH (age 44.23±4.67, 56% female) without any cardiac disease, and 20 age and sex-matched healthy controls. Among 25 patients 18 had chronic obstructive pulmonary disease, 3 had chronic thromboembolic PH and the rest had systemic lupus erythematosus. Patients with intrinsic LV diseases were excluded. Conventional echocardiography and speckle tracking- based strain imaging were performed to analyze LV twist mechanics.
Left ventricular end diastolic diameter, LV end systolic diameter and LV ejection fraction were similar between the groups. Right ventricular (RV) diameter was significantly increased in patients with PH (3.2±0.22 cm to 2.29±0.12 cm; p=0.0001). Left ventricular eccentricity index (EI) was also increased in the patient group, when compared to healthy controls (1.35±0.23 to 0.93±0.11; p=0.0001). Left ventricular torsion was markedly impaired in PH group, compared with control subjects (5.88±2.33° to 14.9±2.26°; p=0.0001), demonstrating decreased LV twist mechanics. Additionally, we revealed that LV torsion was negatively correlated with pulmonary artery systolic pressure (r=-0.863, p=0.0001) and LV EI (r=-0.684, p=0.0001).
Chronic RV pressure overload influences LV geometry. LV torsion analysis based on speckle tracking echocardiography may provide insights into the impact of RV pressure overload on LV performance.