Journal of Echocardiography

, Volume 7, Issue 2, pp 25–33 | Cite as

Right ventricular diastolic dysfunction in patients with left ventricular hypertrophy: analysis of right ventricular myocardial relaxation using two-dimensional speckle tracking imaging

  • Sanae Kaga
  • Taisei Mikami
  • Hisao Onozuka
  • Satomi Omotehara
  • Ayumu Abe
  • Satoshi Yamada
  • Masako Okada
  • Hiroshi Komatsu
  • Mamiko Inoue
  • Shinobu Yokoyama
  • Mutsumi Nishida
  • Chikara Shimizu
  • Kazuhiko Matsuno
  • Hiroyuki Tsutsui
Original Investigation

Abstract

Background

Although several previous studies have suggested the presence of right ventricular (RV) diastolic dysfunction in patients with hypertrophic cardiomyopathy (HCM) and those with hypertensive left ventricular hypertrophy (HT-LVH), the mechanisms are still unclear. This study aimed to clarify the relationship between the RV global diastolic dysfunction in these patients and the regional myocardial diastolic function, including synchronicity of the interventricular septum and RV free wall.

Methods

In 20 age-matched patients with HT-LVH, 20 patients with HCM and 22 control subjects without pulmonary hypertension, RV isovolumic relaxation time (IRTR) was measured using continuous-wave Doppler echocardiography. The early diastolic peak strain rate (ESR) and time from QRS to ESR (TESR) were measured in the apical, mid-ventricular and basal segments of the interventricular septum and RV free wall using two-dimensional speckle tracking imaging (2DST).

Results

IRTR was more prolonged both in HT-LVH and in HCM than in the controls. The averaged septal ESR was reduced both in HT-LVH and in HCM (P < 0.0001, respectively), but the averaged RV free wall ESR was decreased only in HCM (P = 0.0007). ESR averaged for six septal and RV free wall segments was correlated with IRTR (r = −0.46, P = 0.0001). Neither intergroup difference nor correlation with IRTR was observed in a coefficient of variation of TESR for the six segments.

Conclusions

RV global diastolic function is impaired in patients with HT-LVH and HCM due to relaxation abnormalities, not an asynchrony, of the myocardium surrounding the RV cavity. The detection of RV free wall relaxation abnormality using 2DST may be useful to differentiate HCM from HT-LVH.

Keywords

Right ventricular diastolic function Left ventricular hypertrophy Hypertension Hypertrophic cardiomyopathy Two-dimensional speckle tracking imaging 

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Copyright information

© Japanese Society of Echocardiography 2009

Authors and Affiliations

  • Sanae Kaga
    • 1
  • Taisei Mikami
    • 2
  • Hisao Onozuka
    • 2
  • Satomi Omotehara
    • 1
  • Ayumu Abe
    • 2
  • Satoshi Yamada
    • 3
  • Masako Okada
    • 3
  • Hiroshi Komatsu
    • 3
  • Mamiko Inoue
    • 1
  • Shinobu Yokoyama
    • 1
  • Mutsumi Nishida
    • 1
  • Chikara Shimizu
    • 1
  • Kazuhiko Matsuno
    • 1
  • Hiroyuki Tsutsui
    • 3
  1. 1.Division of Laboratory and Transfusion MedicineHokkaido University HospitalSapporoJapan
  2. 2.Faculty of Health SciencesHokkaido University Graduate SchoolSapporoJapan
  3. 3.Department of Cardiovascular MedicineHokkaido University Graduate School of MedicineSapporoJapan

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