Chronic pulmonary hypertension shortens the duration of mitral annular systolic and diastolic tissue doppler signals

Some data suggests that both left ventricular (LV) systolic and diastolic function are impaired in patients with chronic pulmonary hypertension (cPH); however, a clear understanding of these specific abnormalities remains poorly characterized. LV systolic and diastolic function as well as LV myocardial performance index (MPI) were obtained and compared to total duration of mitral annular (MA) TDI systolic (MASTDId) and diastolic (MADTDId) measurements, corrected for heart rate, in 20 controls (Group I: mean 53 ± 18 years) and 30 patients (Group II: mean 55 ± 14 years) with cPH. Group II patients had relatively faster heart rates (75 ± 14 bpm vs. 63 ± 12 bpm; P < 0.003), higher LV ejection fraction (78 ± 10% vs. 68 ± 6%; P < 0.0004), similar MA systolic excursion (1.4 ± 0.2), unchanged MA TDI Ea/Aa ratios (0.86 ± 0.46 vs. 1.05 ± 0.41; P = 0.15), significantly higher LV MPI (0.98 ± 0.56 vs. 0.60 ± 0.11; P < 0.004), with a significantly shorter heart rate corrected MASTDId (251 ± 66 ms vs. 305 ± 30 ms; P < 0.001) and MADTDId (378 ± 87 ms vs. 497 ± 114 ms; P < 0.0001) than Group I. It appears that cPH shortens the total duration of both MA systolic and diastolic TDI intervals. Whether this is a result of altered LV geometry and/or confounded by the presence of relatively faster heart rates in cPH patients will require further study.