Right Ventricular Remodeling in Patients with Pulmonary Hypertension due to Left Heart Disease at the Douala General Hospital, Cameroon: An Echocardiographic Study.
Martin ABANDA ; Leopold AMINDE ; Felicité KAMDEM ; Bonvaventure DZEKEM ; Anastase DZUDIE
CaHReF 20116, Yaoundé Conges hall, 23 – 26 August 2016 , PL095
Right ventricular (RV) dysfunction has been shown to occur early and has major prognostic implications for patients with group 1 pulmonary hypertension (PH), but in patients with PH due to left heart disease (LHD), data is scarce. We aimed to compare echocardiographic right ventricular changes in patients having left heart disease with pulmonary hypertension (PHLHD) and left heart disease no pulmonary hypertension (LHDnPH) at the Douala General Hospital.
This was a cross sectional study. All participants had detailed echocardiographic study with structural and functional RV assessment. PH was defined as an estimated right ventricular systolic pressure > 35 mm Hg. Thirty four patients with PHLHD were compared to sixty five patients with LHDnPH. Chi-square and Student T-tests were used to compare categorical and continuous variables respectively on SPSS v. 22.
Overall, mean age was 59.1 years and 56.6% were female with no age or sex difference between LHDnPH and PHLHD group. Patients with PHLHD had a longer duration of hypertension (9.6 vs 4.8 years, p=0.001) and presented with more dyspnea, cough, fatigue, pedal edema and lower systolic and diastolic blood pressure. RV free wall thickness (0.8±0.2cm vs 0.6±0.2cm, p=0.014), RV basal diameter (4.1±0.7cm vs 3.6±0.6cm, p<0.001), and RA area (21.6±8.1cm2 vs 13.9±3.4 cm2, p<0.001) were higher in those with PHLHD compared to LHDnPH, while Tricuspid Annular Plan Systolic Excursion - TAPSE (1.9±0.5cm vs 2.3±0.5cm, p<0.001) was lower in PHLHD.
Our findings suggest that right ventricular changes occur in parallel with progressing left heart disease and probably worsen with superimposition of pulmonary hypertension. A multicenter study of a larger sample is warranted to confirm these findings.
Right ventricle, remodeling, left heart disease, pulmonary hypertension, echocardiography