Table 3.
Left Ventricular Echocardiographic Variables
| Control Subjects (n = 53) | PH Patients (n = 53) | P Value | Severe PH (n = 13) | P value | |
|---|---|---|---|---|---|
| 2-Dimensional Measures | |||||
| End-Diastolic Eccentricity Index | 1.02 (0.96 - 1.06) | 1.18 (1.09 - 1.28) | <0.0001* | 1.43 (1.15 - 1.76) | 0.043* |
| End-Systolic Eccentricity Index | 0.99 (0.96 - 1.03) | 1.27 (1.11 - 1.50) | <0.0001* | 1.82 (1.30 - 2.17) | 0.005* |
| End-Diastolic Volume, ml | 49.0 (29.0 - 79.5) | 52.0 (26.0 - 90.0) | 0.25 | 77.0 (39.0 - 105.0) | 0.75 |
| Indexed End-Diastolic Volume, ml/m2 | 37.9 (32.8 - 48.4) | 44.3 (37.2 - 59.8) | 0.07 | 61.5 (45.6 - 82.4) | 0.61 |
| End-Systolic Volume, ml | 16.5 (9.5 - 27.5) | 19.0 (12.0 - 46.0) | 0.004* | 33.0 (16.0 - 47.0) | 0.46 |
| Indexed End-Systolic Volume, ml/m2 | 12.9 (9.8 - 16.5) | 20.3 (14.2 - 28.1) | 0.0006* | 23.5 (21.4 - 33.1) | 0.24 |
| Biplane Ejection Fraction, % | 66.0 (62.0 - 69.0) | 56.0 (50.0 - 63.0) | <0.0001* | 58.0 (50.0 - 66.0) | 0.015* |
| Doppler Measures | |||||
| Pulmonary Vein | |||||
| S, m/s | 0.46 (0.38 - 0.49) | 0.31 (0.27 - 0.37) | <0.0001* | 0.28 (0.20 - 0.34) | 0.0063* |
| D, m/s | 0.60 (0.53 - 0.67) | 0.46 (0.40 - 0.55) | <0.0001* | 0.42 (0.40 - 0.47) | 0.045* |
| S/D Ratio | 0.75 (0.65 - 0.86) | 0.71 (0.56 - 0.83) | 0.22 | 0.62 (0.57 - 0.83) | 0.25 |
| A, m/s | 0.16 (0.13 - 0.18) | 0.15 (0.12 - 0.19) | 0.84 | 0.16 (0.13 - 0.19) | 0.89 |
| A Duration, msec | 68.0 (59.0 - 83.0) | 85.0 (69.0 - 107.0) | <0.0001* | 91.0 (70.0 - 107.0) | 0.12 |
| Mitral Valve | |||||
| E, m/s | 0.96 (0.85 - 1.10) | 0.86 (0.73 - 0.93) | 0.011* | 0.74 (0.71 - 0.82) | 0.035* |
| A, m/s | 0.47 (0.39 - 0.57) | 0.49 (0.34 - 0.72) | 0.12 | 0.49 (0.39 - 0.62) | 0.14 |
| E/A | 1.99 (1.66 - 2.54) | 1.80 (1.16 - 2.87) | 0.53 | 1.54 (1.08 - 2.04) | 0.12 |
| E Deceleration Time, msec | 133.0 (121.0 - 170.0) | 179.0 (137.0 - 210.0) | 0.0002* | 222.5 (153.5 - 279.5) | 0.032* |
| Inflow Duration, msec | 400.5 (306.5 - 579.0) | 363.0 (263.0 - 497.5) | 0.013* | 416.0 (304.5 - 497.5) | 0.37 |
| PVAD/MVAD | 0.65 (0.57 - 0.79) | 0.72 (0.62 - 0.84) | 0.017* | 0.70 (0.67 - 0.78) | 0.18 |
| PVAD - MVAD | −38.0 (−48.0 - −20.0) | −29.5 (−45.0 - −14.0) | 0.09 | −30.0 (−45.0 - −20.0) | 0.31 |
| RV/LV Systolic Duration | 1.01 (0.98 - 1.032) | 1.12 (1.06 - 1.18) | <0.0001* | 1.19 (1.14 - 1.30) | 0.0005* |
| Tissue Doppler Imaging | |||||
| Lateral Mitral E′, cm/s | 18.8 (16.0 - 20.2) | 12.0 (9.0 - 15.0) | <0.0001* | 10.0 (8.5 - 13.0) | 0.027* |
| Lateral Mitral A′, cm/s | 6.4 (5.4 - 7.9) | 6.0 (4.0 - 7.0) | 0.15 | 6.0 (4.0 - 7.0) | 0.03* |
| Lateral Mitral E′/A′ | 2.9 (2.3 - 3.3) | 2.1 (1.7 - 3.0) | 0.001* | 1.9 (1.7 - 2.5) | 0.16 |
| Septal E′, cm/s | 14.5 (13.0 - 16.0) | 9.0 (7.0 - 11.0) | <0.0001* | 7.0 (6.0 - 9.0) | 0.0003* |
| Septal A′, cm/s | 6.3 (5.9 - 7.0) | 5.0 (4.0 - 6.0) | 0.0002* | 5.0 (3.5 - 6.0) | 0.0303* |
| Isovolumic Relaxation Time, msec | 47.0 (38.0 - 52.0) | 58.0 (48.0 - 72.0) | 0.0003* | 76.5 (56.5 - 98.5) | 0.009* |
| Mitral Valve E/E′ | 5.2 (4.5 - 6.0) | 7.2 (6.0 - 9.5) | <0.0001* | 7.3 (6.0 - 8.9) | 0.033* |
| Speckle-Tracking Echocardiography | |||||
| Global DLSR, 1/s | 2.17 (1.84 - 2.68) | 2.08 (1.53 - 2.45) | 0.05 | 1.55 (1.26 - 2.08) | 0.05 |
| Basal Global DCSR, 1/s | 2.05 (1.54 - 2.78) | 1.44 (1.20 - 2.48) | 0.019* | 1.19 (1.13 - 1.68) | 0.023* |
| Mid Global DCSR, 1/s | 1.78 (1.42 - 2.10) | 1.68 (1.23 - 1.99) | 0.06 | 1.22 (1.09 - 1.74) | 0.17 |
| Apical Global DCSR, 1/s | 2.48 (1.73 - 2.79) | 2.34 (1.67 - 2.85) | 0.88 | 1.85 (1.29 - 2.52) | 0.44 |
| Apical Recoil, °/s | −49.8 (−18.9 - −75.5) | −80.9 (−49.2 - −107.2) | 0.0009* | −72.6 (−52.5 - −95.5) | 0.0008* |
| Basal Recoil, °/s | 39.4 (18.1 - 54.1) | 16.4 (7.3 - 41.2) | 0.70 | 15.9 (−3.3 - 38.3) | 0.17 |
| Indexed Diastolic Untwist Rate, °/s/cm | −11.3 (−7.8 - −16.4) | −15.4 (−11.5 - −22.4) | 0.003* | −14.9 (−8.3 - −15.4) | 0.0162* |
Presented as median (interquartile range). PH indicates pulmonary hypertension; S, systolic pulmonary vein flow; D, diastolic pulmonary vein flow; A, pulmonary vein flow during atrial contraction; E, early transmitral flow velocity; A, late transmitral flow velocity; PVAD; pulmonary vein A duration; MVAD, mitral valve A duration; RV, right ventricle; LV, left ventricle; E′, peak early diastolic myocardial annular velocity; A′, peak late diastolic myocardial annular velocity; DLSR, diastolic longitudinal strain rate; DCSR, diastolic circumferential strain rate. Severe PH patients are compared to their matched controls (not shown).
*
P<0.05.