Association between myocardial right ventricular relaxation time and pulmonary arterial pressure in chronic obstructive lung disease: Analysis by pulsed Doppler tissue imaging

This study assessed right ventricular function in chronic obstructive lung disease and pulmonary hypertension by Doppler tissue imaging. Doppler echoc ardiography of the right ventricle and Doppler tissue imaging of the tricus pid annulus were performed in 63 subjects: 20 healthy controls, 20 with lun g disease, and 23 with both lung disease and pulmonary hypertension. Two-di mensional tricuspid systolic plane excursion was lower in patients with pul monary hypertension than in the other 2 groups. Doppler tricuspid inflow me asurements distinguished patients in both of the diseased groups from the c ontrol subjects, but they did not differentiate patients with pulmonary hyp ertension from those without it. The ratio of peak E-wave to peak A-wave ve locities derived by Doppler tissue imaging was significantly lower and the myocardial acceleration time longer in both groups of lung disease than in the control group. only myocardial relaxation time distinguished the 3 grou ps (all P < .01); a gradual increase in time occurred, with the shortest ti me seen in controls, a longer time in patients with chronic obstructive lun g disease without pulmonary hypertension, and the longest time in patients with lung disease and pulmonary hypertension. In the overall population inc luding subjects with at least minimal tricuspid regurgitation, myocardial r elaxation time was positively related to pulmonary systolic pressure. In co nclusion, Doppler tissue imaging distinguishes subsets of patients affected by lung disease with or without pulmonary hypertension and identifies pati ents with different levels of pulmonary artery systolic pressure.