Olga Vriz1,2, Mario Pirisi3, Eduardo Bossone4, Fadl ElMula Mohammed Fadl ElMula1, Paolo Palatini5, Robert Naeije6. 1. Heart Centre Department, King Faisal Specialist Hospital & Research Center, Riyadh, Kingdom of Saudi Arabia. 2. Cardiology and Emergency San Antonio Hospital, San Daniele del Friuli. 3. Department of Translational Medicine, Università del Piemonte Orientale, Novara. 4. U.O.C Riabilitazione Cardiovascolare, A Cardarelli, Naples. 5. Senior Scholar, Studium Patavinum of the University of Padova, Italy. 6. Department of Cardiology, Erasmus University Hospital, Brussels, Belgium.
Abstract
BACKGROUND: Mild-to-moderate hypertension with preserved left ventricular (LV) function may be associated with right ventricular (RV) dysfunction and increased pulmonary vascular resistance (PVR). METHODS: The present study explored the adequacy of RV-pulmonary arterial (PA) coupling in 211 never-treated hypertensive patients (mean blood pressure, BP 112 ± 12 mmHg) and 246 controls (BP 93 ± 12 mmHg). They underwent a comprehensive transthoracic Doppler echocardiography, and RV-PA coupling was estimated by the tricuspid annular plane systolic excursion (TAPSE) to systolic pulmonary artery pressure (PASP) ratio (TAPSE/PASP). RESULTS: Compared with the controls, hypertensive patients had increased LV wall thickness and decreased trans-mitral E/A with only slight but significant increase in transmitral Doppler E wave to tissue Doppler mitral annulus e' wave ratio (6.3 ± 1.9 vs. 5.8 ± 1. 5, P < 0.05). RV dimensions and indices of either systolic or diastolic function were not different. PASP was increased in the hypertensive patients (25 ± 7 vs. 21 ± 7 mmHg, P < 0.001), as was PVR estimated from the tricuspid regurgitation velocity to right ventricular outflow tract velocity ratio (1.7 ± 0.4 vs. 1.5 ± 0.5 Wood units, P < 0.001). The TAPSE/PASP ratio was decreased (1.08 ± 0.35 vs. 1.43 ± 0.67 mm/mmHg, P < 0.001). This difference was mainly driven by male hypertensive patients. At multivariable analysis, the only independent predictors of decreased TAPSE/PASP were age and blood pressure. CONCLUSION: The TAPSE/PASP is markedly decreased in hypertension without heart failure, chiefly in men, with only slight increases in estimates of LV filling pressure or PVR, suggesting RV-PA uncoupling.
BACKGROUND: Mild-to-moderate hypertension with preserved left ventricular (LV) function may be associated with right ventricular (RV) dysfunction and increased pulmonary vascular resistance (PVR). METHODS: The present study explored the adequacy of RV-pulmonary arterial (PA) coupling in 211 never-treated hypertensivepatients (mean blood pressure, BP 112 ± 12 mmHg) and 246 controls (BP 93 ± 12 mmHg). They underwent a comprehensive transthoracic Doppler echocardiography, and RV-PA coupling was estimated by the tricuspid annular plane systolic excursion (TAPSE) to systolic pulmonary artery pressure (PASP) ratio (TAPSE/PASP). RESULTS: Compared with the controls, hypertensivepatients had increased LV wall thickness and decreased trans-mitral E/A with only slight but significant increase in transmitral Doppler E wave to tissue Doppler mitral annulus e' wave ratio (6.3 ± 1.9 vs. 5.8 ± 1. 5, P < 0.05). RV dimensions and indices of either systolic or diastolic function were not different. PASP was increased in the hypertensivepatients (25 ± 7 vs. 21 ± 7 mmHg, P < 0.001), as was PVR estimated from the tricuspid regurgitation velocity to right ventricular outflow tract velocity ratio (1.7 ± 0.4 vs. 1.5 ± 0.5 Wood units, P < 0.001). The TAPSE/PASP ratio was decreased (1.08 ± 0.35 vs. 1.43 ± 0.67 mm/mmHg, P < 0.001). This difference was mainly driven by male hypertensivepatients. At multivariable analysis, the only independent predictors of decreased TAPSE/PASP were age and blood pressure. CONCLUSION: The TAPSE/PASP is markedly decreased in hypertension without heart failure, chiefly in men, with only slight increases in estimates of LV filling pressure or PVR, suggesting RV-PA uncoupling.
Authors: Bradley A Maron; Gabor Kovacs; Anjali Vaidya; Deepak L Bhatt; Rick A Nishimura; Susanna Mak; Marco Guazzi; Ryan J Tedford Journal: J Am Coll Cardiol Date: 2020-12-01 Impact factor: 24.094
Authors: Na Zhou; Kevin Forton; Yoshiki Motoji; Corentin Scoubeau; Malgorzata Klass; Robert Naeije; Vitalie Faoro Journal: Front Cardiovasc Med Date: 2022-08-19
Authors: Olga Vriz; Paolo Palatini; Lawrence Rudski; Paolo Frumento; Jarosław D Kasprzak; Francesco Ferrara; Rosangela Cocchia; Luna Gargani; Karina Wierzbowska-Drabik; Valentina Capone; Brigida Ranieri; Andrea Salzano; Anna Agnese Stanziola; Alberto Maria Marra; Roberto Annunziata; Salvatore Chianese; Salvatore Rega; Teresa Saltalamacchia; Renato Maramaldi; Chiara Sepe; Giuseppe Limongelli; Filippo Cademartiri; Antonello D'Andrea; Michele D'Alto; Raffaele Izzo; Nicola Ferrara; Ciro Mauro; Antonio Cittadini; Grünig Ekkehard; Marco Guazzi; Eduardo Bossone Journal: J Clin Med Date: 2022-01-17 Impact factor: 4.241