Russian Heart Failure Journal 2015year Right ventricular diastolic dysfunction in patients with arterial hypertension: clinico-echocardiographic correlations


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2015/№1

Right ventricular diastolic dysfunction in patients with arterial hypertension: clinico-echocardiographic correlations

Sumun A. N.1, Shushunova O. V.2, Arkhipov O. G.2
1 - Federal State Budgetary Institution "Research Institute for Complex Issues of Cardiovascular Diseases" at the Siberian Branch of the Russian Academy of Medical Sciences, Sosnovy Bulvar 6, Kemerovo 650002
2 - Federal Budgetary Institution Rehabilitation Center of the RF Social Insurance Fund "Topaz", Leskhoznaya 1, Myski 652840, Kemerovo Region

Keywords: arterial hypertension, heart rate variability, diastolic dysfunction of the right ventricle

DOI: 10.18087/rhfj.2015.1.2022

Background. Arterial hypertension (AH) can result in disorders of LV structure and geometry. The right ventricle (RV) also may be involved in this process. Aim. To study clinical-EchoCG correlations in AH patients with RV diastolic dysfunction. Materials and methods. 127 patients with essential hypertension were evaluated. ECG, color-flow duplex scanning of carotid and iliofemoral arteries, and analysis of heart rhythm variability (HRV) were performed for all patients. Patients were divided into two groups: group 1 with preserved RV function (n=85) and group 2 with RV dysfunction (n=42). Results. The group of patients with diastolic dysfunction contained 2.5 times more smokers (р=0.02). Intima-media thickness (IMT) of common femoral arteries was 19 % greater in these patients (р=0.01). In patients with RV diastolic dysfunction, comparison of EchoCG structural parameters showed a tendency for increased RV wall thickness (p=0.06); a significant increase in RV hypertrophy index (р=0.0086); 6 % reduced tricuspid annular plane systolic excursion (р=0.050); significantly prolonged LV isovolumic relaxation time (IVRT) (р=0.002); reduced early filling velocity (E) (р=0.029) and Е / А (р=0.044); and reduced mitral flow propagation velocity (р=0.018). The RV Tei index was considerably increased compared to the reference group (р=0.0002). The number of patients with increased autonomic sympathetic tone was greater (р=0.024). The multiple logistic regression analysis showed that smoking (OR, 6.54; р=0.01), increased LV IVRT >87 msec (OR, 3.25; р=0.002), increased LV Tei index >0.55 (OR, 4.61; р=0.016), and sympathicotonia (OR, 4.4; р=0.025) were independent factors associated with RV diastolic dysfunction. Conclusion. 33 % of AH patients had RV diastolic dysfunction. The proportion of smokers was greater among AH patients with RV diastolic dysfunction; these patients had greater IMT, higher RV hypertrophy index, and higher rates of carotid stenosis, RV hypertrophy and sympathicotonia. Independent predictors of RV diastolic dysfunction identified by the multiple logistic regression analysis were smoking, sympathicotonia, prolonged LV IVRT and impaired LV performance.
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Sumin A. N., Shushunova O. V., Arkhipov O. G. Right ventricular diastolic dysfunction in patients with arterial hypertension: clinico-echocardiographic correlations. Russian Heart Failure Journal. 2015;16 (1):22–30

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