The Prevalence of Left Ventricular Hypertrophy and Altered Geometry in Patients with Right Ventricular Diastolic Dysfunction
|Maiello Maria1, Rakesh K Sharma2, Marco Matteo Ciccone3, Hanumanth K Reddy2 and Pasquale Palmiero4*|
|1Cardiology Department, Italy|
|2Medical Center of South Arkansas, El Dorado, University of Arkansas for Medical Sciences, USA|
|3Cardiology Chair, University of Bari, Italy|
|4Cardiology Department, Brindisi, ASL BR, Brindisi District, Italy|
|Corresponding Author :||Pasquale Palmiero, MD
Cardiology Department 72100
Brindisi, via Francia 47, Italy
Fax: +39 0831 536556
E-mail: [email protected]
|Received September 29, 2011; Accepted November 17, 2011; Published November 21, 2011|
|Citation: Maria M, Sharma RK, Ciccone MM, Reddy HK, Palmiero (2011) The Prevalence of Left Ventricular Hypertrophy and Altered Geometry in Patients with Right Ventricular Diastolic Dysfunction. J Clinic Experiment Cardiol 2:162. doi:10.4172/2155-9880.1000162|
|Copyright: © 2011 Maria M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Background: Left ventricular diastolic dysfunction (LVDD) associated with left ventricular hypertrophy (LVH) has been reported to play a major role in cardiovascular heart failure. Although, right ventricular diastolic dysfunction (RVDD) in patients with LVH was known to be clinically relevant, no systematic study had been performed regarding this relationship between left ventricular (LV) geometry associated with LVH and RVDD. The goal of this study was to evaluate an association between RVDD; LVDD, LVH and LV altered geometry for early diagnosis of heart failure.
Methods and Results: Out of 426 patients, 396 patients (93%) were found to have both RVDD and LVDD. In this cohort, LV concentric geometry (LVCG) was identified in 138 patients (32.3%). RVDD and LVDD were diagnosed by measurement of E/A and tissue doppler imaging (E’/A’) for mitral and tricuspid valves. The mean value of mitral E/A in the LVCG group was lower than that of controls; 0.63±0.03 vs. 1.44±0.03, p<0.02. Mitral E’/A’ was also lower in LVCG than that of controls; 0.60±0.02 vs. 1.36±0.03, p<0.01. Similarly, E/A of Tricuspid valve in patients with LVCG was found to be lower than E/A of Tricuspid valve of controls; 0.52±0.07 vs. 0.69±0.02, p<0.001 and E’/A’ of tricuspid valve was lower than that of controls; 0.44±0.02 vs. 0.63±0.06, p<0.05.
Conclusions: This study demonstrated that simple doppler trans-valvular inflow parameters and tissue doppler imaging may identify patients with biventricular diastolic dysfunction. This finding was more often observed in patients with LV concentric geometry, a pattern associated with an increased risk of cardiovascular events.