Right Ventricular Function Assessed by Two-Dimensional Strain and Tissue Doppler Echocardiography in Patients With Pulmonary Arterial Hypertension and Effect of Vasodilator Therapy

Two-dimensional strain echocardiography is a new method for the assessment of regional contractility. Thirty-seven patients with pulmonary arterial hypertension (mean age 56.4 ± 11 years) and 38 normal subjects (mean age 58.3 ± 12 years) underwent 2-dimensional echocardiography and tissue Doppler echocardiographic evaluation of right ventricular (RV) global function and regional contractility. Patients with pulmonary arterial hypertension additionally underwent 6-minute walking distance tests and right-sided cardiac catheterization before and after (8 ± 3 months) vasodilator therapy. Moderate or severe RV dysfunction was present in all patients (2-dimensional strain of the basal segment of the RV free wall: −8.8 ± 4.1% systolic longitudinal deformation) compared with normal subjects (−24.3 ± 4.7% systolic longitudinal deformation, p <0.001) and was improved with vasodilator therapy after 6 to 11 months (−13.3 ± 6.2% systolic longitudinal deformation, p <0.001).