Assessment of Right Ventricular Function among Hypertensive Patients Using Pulse Tissue Doppler

Classically, one’s heart function is mostly based upon its systolic functiom, whereas the diastolic function steps on second order. In recent years it has been revealed that diastolic function plays an important role in both cardiac mortality and cardiac morbidity. On the other hand is hypertension which due to increasing the afterload, interferes with these functions of heart. In this study we assessed the diastolic function of hypertensive patients using pulse tissue Doppler. 30 patients with high blood pressure that had not consumed anti-hypertensive agents and along with 30 healthy control ones enrolled in our survey, all of whom had normal sinus rhythm without detectable symptoms corresponding to congestive heart failure, ischemia, valvular diseases and pulmonary problems. 2D echocardiography was performed in both groups as well as M Mode and Doppler ech. The PTD echo was performed by the lateral annulus of both tricuspid and mitral valves. Systolic and diastolic findings were measured by PTD. Hypertensive patients had negative diastolic findings but no negative systolic ones. PTS illustrated that E/A ratio (early peak velocity / late peak velocity) in right ventricle had significantly decreases (P<0.01) among these patients. In right ventricle, both RT (relaxation time)(P<0.01), DT (decelation time)(P<0.04) and Am (Late Peak Velocity) (P<0.03) were converesly increased. Right ventricular E/A ratio had a significant correlation with that of left ventricl (P<0.005, r =0.5). It seems that hypertension is longitudinally related with diastolic disfunction of right ventricle. This disturbance would be represented by the lengthened RT and decreasing of E/A ratio which are both resulted from interfering of two ventricle’s function and increased pressure of left ventricle. Therefore, PTD can be applied to evaluate the right ventricular diastolic function among patients with high blood pressure.