Abstract
The purpose: To estimate dynamics of right and left ventricular systolic and diastolic function by estimation Sa, Ea of the lateral tricuspid and mitral valve annulus during acute pharmacological testing (APhT)with inhaled nitric oxide (iNO)in patients with idiopathic pulmonary arterial hypertension (IPAH).Materials and methods:In the study we included 11 pts (11 females)with IPAH aged 31-51 (mean age 39,8± 7,4years). All pts were performed right heart catheterization (RHC)with APhT and noninvasive vasodilator testing with iNO (20ppm for 10min)before two hours to RHC. The estimation of SPAP was performed initially at rest and then at 10min of nitric oxide Inhalation. All pts were responders. Echo included routing parameters and TVI was used for the estimation of systolic and diastolic function of RV/LV before and after APhT. Results: In pts with IPAH (functional class II-III, WHO)the mean value of tricuspid regurgitation (TR) gradient was 64,8±11,5mmHg. In all pts included in the study the degree of TR was at least III. Taking into account right atrial pressure levels mean SPAP was 75±11,6mmHg by Transthoracic Doppler Echocardiography(TDEcho.)before APhT. Mean SPAP was 47,5±6,2mmHg. by echo after APhT. According to RHC data mean SPAP was 76,8±16,6mmHg. before test and 46,6±7,9mmHg after iNO. We found no significant dynamic of routine echo parameters.To 10'of iNO there was significant improvement Sa,Ea of RV during APhT with iNO. There was improvement Sa,Ea of LV but not significant. Conclusion: TDEcho. may be used for an accurate assessment of vasodilator response as compared to RHC data. During APht with iNO only Sa, Ea of RV may be used for detecting vasoreactive patients.
- © 2012 ERS
