Echocardiographic assessment of right ventricle diastolic function in patients with multivessel coronary artery disease

• Main Authors: Yu. S. Sinelnikov, E. N. Orekhova, O. A. Osetrova, O. A. Balyshova
• Format: Article
• Language: Russian
• Published: Meshalkin National Medical Research Center 2017-07-01
• Series: Патология кровообращения и кардиохирургия
• Subjects: правый желудочек; эхокардиография; систолическая и диастолическая дисфункция правого желудочка; продольная деформация
• Online Access: http://journalmeshalkin.ru/index.php/heartjournal/article/view/381

<p><strong>Aim.</strong> The study was aimed at assessing the right ventricle diastolic function in patients with multivessel coronary artery disease.</p><p><strong>Methods.</strong> 62 patients (32 males (51.6 %)) with multivessel coronary artery disease (SYNTAX Score 33.04±4.1) were examined over a period from 2014 to 2016. The mean age was 58.5±8.3 years). To examine the diastolic function of the left and right ventricles (LV, RV), conventional echocardiographic (EchoCG) parameters, as well as a longitudinal diastolic strain rate at the level of RV free wall segments were analyzed by using tissue Doppler imaging in 2D strain imaging mode.</p><p><strong>Results.</strong> The systolic function of both ventricles was moderately decreased (LV EF 43.2 ± 5.5%, RV EF 42±6 %). 41 patients (66.1 %) demonstrated LV diastolic dysfunction (DD, impaired relaxation) of grade I and 46 patients (74.2 %) – RV DD of grade I. Pseudonormal LV DD grade II was revealed in 18 patients (29 %) and RV DD of grade II – in 15 patients (24.2 %). 3 patients (4.8 %) had LV DD (restrictive) of grade III and only 1 patient (1.6 %) showed a restrictive type of RV filling. The early diastolic strain rate (E_SR) was 0.86±0.18 s^–1in patients with DD of grade I, the late diastolic strain rate was 0.88±0.27 s^–1 (A_SR), with their ratio E_SR / A_SR running to 0.99±0.16. For patients with DD of grade II, E_SR was 0.62±0.04 s^–1, A_SR – 0.41±0.04 s^–1and the ratio of E_SR / A_SR – 1.5±0.19. For patients with DD of grade III (n = 1), E_SR was 0.41 s^–1, A_SR– 0.2 s^–1 and the ratio E_SR / A_SR – 2.05.  A significant inverse correlation between the coronary artery disease complexity (SYNTAX Score) and the strain rate in the early diastolic phase of RV filling E_SR (RS = –0.73, p = 0.001) was identified.</p><p><strong>Conclusion.</strong> Longitudinal systolic strain and diastolic strain rate decrease in parallel, thus reflecting a close relation of systolic and diastolic mechanics of the right ventricle. The intensity of right ventricle diastolic dysfunction is associated with the coronary artery disease complexity.</p><p>Received 18 October 2016. Accepted 6 February 2017.</p><p><strong>Financing:</strong> The study required no additional funding and sponsorship.</p><p><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p><p><strong>Author contributions</strong></p><p>Conception and study design: E.N. Orekhova, O.A. Osetrova.<br />Data collection and analysis: O.A. Osetrova, O.A. Balyshova.<br />Drafting the article: E.N. Orekhova, O.A. Osetrova.<br />Critical revision of the article: Yu.S. Sinelnikov, E.N. Orekhova.<br />Final approval of the version to be published: Yu.S. Sinelnikov, E.N. Orekhova, O.A. Osetrova, O.A. Balyshova.</p>