Right ventricular (RV) myocardial fibers are in continuity with those of left ventricle (LV).
Aim: Assessment of the effects of LV wall motion abnormalities (WMA) on RV systolic function at rest and after stress.
Methods: Fifty nine subjects, 15 with LV-WMA underwent dobuatmine stress echocardiography (DSE) studies using the usual protocol. Measurement of tricuspid annular plane systolic excursion (TAPSE), velocity (TASV), mitral annular plane systolic excursion (MAPSE) and velocity (MASV), were performed before and immediately after DSE studies.
Results: TAPSE was lower, in those with LV-WMA than in those without, both at rest 20.5±4.8 mm versus 24.9±4.7 mm, p=0.015 and after DSE studies, 21.5±5.6 mm versus 27.65±5.7 mm, p=0.005. DSE studies did not change TAPSE significantly in the presence of LV-WMA. TASV at rest in those with LV-WMA was 16.5±2.7 cm/sec and similar to that in those without, 17.6±3 cm/sec. In both groups the velocity increased after DSE studies, 23.25±7.5 cm/sec, p=0.01 with LV-WMA, and 27.5±6 cm/sec, p=0.0005, without LV-WMA. Despite similar TASV at rest, the TAPSE/TASV ratio, indicating duration of shortening, was lower (124±21 msec) in subjects with of LV-WMA, than in those without (145±27 msec), p=0.0065, implying increased afterload for RV longitudinal shortening in the presence of LV-WMA.
Conclusions: TAPSE is lower at rest and after DSE in subjects with LV-WMA than in subjects without; however, DSE increased TPASE only in the absence of LV-WMA. TASV increased after DSE and was similar at rest in both groups.. It seems that LV-WMA increases afterload to RV longitudinal motion.
