Doppler Echocardiographic Evaluation of Right Ventricular Diastolic Function in Patients with Mitral Regurgitation

Georgios K. Efthimiadis MD, Georgios E. Parharidis MD, Ioannis N. Dourvas MD, Haralambos I. Karvounis MD, Konstantinos D. Gemitzis MD, Gregorios K. Savvopoulos MD, Ioannis H. Styliadis MD, Takis N. Karoulas MD, Georgios E. Louridas MD

 
Background and aim of the study: The effect of left ventricular (LV) pressure overload on right ventricular (RV) diastolic function has been extensively studied. In contrast, no data are available concerning the influence of LV volume overload on RV diastolic function. Accordingly, RV diastolic function was studied in patients with mitral regurgitation (MR) using Doppler echocardiography.
Methods: RV diastolic indices were calculated, using pulsed Doppler echocardiography, in 30 patients (mean age 56.87 ± 8.58 years) with severe MR, and in 30 healthy control subjects (mean age 56.67 ± 8.52 years).
Results: Compared with controls, MR patients had a significantly lower RV E/A ratio (0.85 ± 0.12 versus
1.21 ± 0.16, p <0.001), a significantly prolonged RV isovolumic relaxation time (70 ± 20 versus 30 ± 10 ms, p <0.001), a significantly prolonged deceleration time of the transtricuspid E wave (210 ± 20 versus 140 ± 10 ms, p <0.001), and a significantly greater right atrial filling fraction (38.58 ± 4.59 versus 32.58 ± 3.14%, p <0.001). There was no statistically significant correlation between RV diastolic indices and LV mass index and interventricular septum thickness.
Conclusion: RV diastolic function in patients with MR is impaired, reflecting prolonged relaxation and redistribution of RV filling into late diastole. Ventricular interdependence constitutes the most likely mechanism of this action.
 
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