Posibilities of tissue Doppler echocardiography in diagnosis of right ventricular dysfunction in patients with chronic functional class I-IV heart failure

A left or/and right ventricular (LV, RV) defection can cause chronic heart failure (CHF). It is well known that patients with pronounced RV CHF have worse prognosis and need serious intervention including heart transplantation. But RV non-invasive methods for diastolic dysfunctions are limited. Some of them, for instance Doppler method (DM), have some noticeable restrictions. A Tissue Doppler echocardiography method (TDM) has demonstrated its independence from haemodynamic conditions and heart volume overloads and showed its capability to display a real active myocardium relaxation. TDM can become a real alternative method to study RV diastolic functions and individual prognosis in CHF patients. AIM: To study capabilities of a tricuspid ring TDM in analysis of RV I - IV functional classes CHF patients in comparison with traditional RV and LV DM. MATERIALS AND METHODS: 60 CHF I - IV NYHA classes patients and 20 healthy volunteers (a control group) were studied. For LV and RV general diastolic function study a traditional DM of transtricuspid, transmitral and venous flows was used. A LV and RV TDM was used in impulse-wave mode of a tissue Doppler visualization. RESULTS: The control group of healthy patients displayed a strong correlation between LV and RV diastolic functions. The same correlation was not found in CHF patients group. Using already published medical scientific non-favorable CHF prognosis criteria DM found only 4 patients from 60 (6,7%) but TDM did 20 from 60 (33%). CONCLUSIONS: Some CHF patients have an isolated RV diastolic dysfunction without an accompanying LV diastolic dysfunction or with a pseudonormal diastolic function LV background. Studied risk groups of progressing CHF displayed that a TDM is more informative and effective for RV dysfunctions prognosis than traditional DM.


Kardiologiia. 2007;47(4):18-21
[Article in Russian]


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