Correlation Study Of Right Ventricular Peek Myocardial Acceleration During Isovolumic Contraction And Pulmonary Arterial Systolic Pressure

Objective: To investigate the correlation between right ventricular peakmyocardial acceleration during isovolumic contraction(IVA) and pulmonary arterialsystolic pressure(PASP). Additionally, to investigate whether it can estimate the degreeof PAH.Methods: Eighty-one subjects referred to our hospital between January2011andDecember2012were included in this study. Forty-five patients with pulmonary arterialhypertension（mean age57.8±14.6years old,22males）and36normal control（sgroup1：mean age52.7±14.4years old,19males）were investigated. Patients with pulmonaryarterial hypertension were divided into mild（group2:17cases）and moderate-severe（group3:28cases）groups. The end-diastolic right ventricular wall thickness(RVWd),end-diastolic left ventricular dimension(LVEDD),and end-diastolic right ventriculardimension (RVEDD) were measured by using VIVID-7echocardiography.Tricuspid regurgitation peak velocity (TRV) was measured at the apical four-chamberview. The pulmonary artery systolic pressure (PASP) was calculated according to thefollowing formula: PASP=RVSP=4V2+right artial pressure (RAP), where RVSP standsfor the right ventricular systolic pressure. IVA at the the basal segment of rightventricular free wall were acquired in apical four-chamber view using Doppler tissueimaging. Inter-group comparison of IVA and PASP was evaluated in all the patients ofthe three groups. Additionally, the Pearson correlation between IVA and PASP wasanalyzed. Analyzing results to find out the parameters that play an important role indiagnosing pulmonary arterial hypertension.Results：1. Compared with control group, RVWd and RVEDD in the patients of group2and 3significantly increase（p<0.05）; LVEDD shows decrease in the patients of group2andgroup3（p<0.05）.2. Compared with the control group, RVESA and RVEDA in the patients of group2and3shows increase(p<0.01); RVFCA shows reduced in group2and3(p<0.01),but no statistical difference between group2and3.3. Compared with the control group,IVA shows decrease in the patients of group2and group3（2.6±0.3m/s~2：2.1±0.4m/s~2：1.6±0.5m/s~2，p<0.01）.4. Among all the patients of PH, positive correlation is detected between RVEDDand PASP（r=0.483，p<0.05）, negative correlation is detected between not only RVFCAand PASP (r=﹣0.505，p<0.01), but also IVA and PASP (r=﹣0.750，p<0.01). However,a strict correlation is detected between IVA and PASP only in the group withmoderate-severe pulmonary PAH.5. The multiple stepwise regression analysis is done between RVEDD, RVFCA,IVA and PASP, the regression equation as followed:PASP(mmHg)=101.387+1.272RVEDD(mm)-0.683RVFCA(%)-23.691IVA(m/s~2)Conclusion：1. In the patients of moderate-severe pulmonary PAH, a strict negative correlationis detected between IVA and PASP.2. IVA has more remarkbal correlation with PASP than RVEDD or RVFCA, IVAcan reflect the PAH at the early stage.3. The regression equation of right ventricular echocardiograhpic indexes estimatePASP as followed:PASP(mmHg)=101.387+1.272RVEDD(mm)-0.683RVFCA(%)-23.691IVA(m/s~2)...