Nayak, Krishnananda and Razak, Abdul and Megha, A and Padmakumar, R and Samantha, Jyothi and Varghesea, Sara (2021) Impact of Right Ventricular Function on Left Ventricular Torsion and Ventricular Deformations in Pulmonary Artery Hypertension Patients. Cardiovascular & Hematological Disorders-Drug Targets, 21 (1). pp. 75-83. ISSN 1871529X

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Abstract

Ventricular interdependence in pulmonary arterial hypertension (PAH) by the use of most recent echocardiographic techniques is still rare. The current case-controlled study aims to assess left ventricular (LV) torsion in patients with PAH. Methods: The study included 42 cases of moderate to severe PAH and 42 age and gender-matched healthy controls between March 2016 and January 2018. All the patients and controls undergo routine practice echocardiography using the Vivid 7- chocardiography (2.5MHz transducer) system. Results: The LV twisting parameters, peak basal rotation, peak apical rotation, and twist were similar among both cases and controls, however, LV torsion was significantly (p=0.04) impacted. Right ventricular (RV) longitudinal deformation was clinically significant in the cases compared to controls: RV systolic strain imaging (p=0.001, 95%CI-9.75 to -2.65), RV systolic strain rate (p=0.01, 95%CI-0.99 to -0.09), and RV late diastolic strain rate (p=0.01, 95%CI-0.64 to -0.85). Although PAH did not impact longitudinal LV deformations significantly. At basal level circumferential strain and strain rate were significantly impacted (p=0.005, 95%CI-4.38 to -0.70; p=0.004, 95%- CI-0.35 to -0.07) in the PAH group, while the radial strain was preserved. All RV echocardiographic parameters and LV end-diastolic dimension, LV end- ystolic volume in the PAH were affected significantly (p=0.002, 95%CI-19.91 to -4.46; p=0.01, 95%CI-8.44 to -2.77). However, only a weak correlation (p=0.05, r =-0.20) was found between tricuspid annular plane systolic excursion and LV Tei index. Conclusion: RV pressure overload directly affects RV longitudinal systolic deformation further influences the interventricular septal and LV geometry, which impaired LV torsion.

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