Right ventricular-pulmonary arterial uncoupling in mild-to-moderate systemic hypertension.

摘要: Background: Mild-to-moderate hypertension with preserved left ventricular (LV) function may be associated with right (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) 246 controls (BP 93 mmHg). They underwent a comprehensive transthoracic Doppler echocardiography, RV–PA was estimated by the tricuspid annular plane systolic excursion (TAPSE) to systolic pulmonary artery pressure (PASP) ratio (TAPSE/ PASP). Results: Compared with controls, hypertensive patients had increased LV wall thickness decreased trans-mitral E/A only slight but significant increase in transmitral Doppler E wave to tissue mitral annulus e0 (6.3 1.9 vs. 5.8 1. 5, P < 0.05). RV dimensions indices of either or diastolic function were not different. PASP the hypertensive (25 7 21 mmHg, 0.001), as PVR from regurgitation velocity outflow tract velocity ratio (1.7 0.4 1.5 0.5 Wood units, 0.001). TAPSE/ PASP decreased (1.08 0.35 1.43 0.67 mm/ mmHg, This difference mainly driven by male hypertensive patients. At multivariable analysis, the only independent predictors TAPSE/PASP were age pressure. Conclusion: TAPSE/PASP is markedly in hypertension without heart failure, chiefly men, with only increases estimates filling or PVR, suggesting uncoupling.