Effects of respiration on the velocity of tricuspid regurgitation and estimation of systolic pulmonary artery pressure in patients with right ventricle systolic dysfunction

Figures & data

Table I. Demographic characteristics of the control and RV systolic dysfunction patients.

	Controls (n = 28)	RV systolic dysfunction (n = 32)	P
Age, years	52.3 ± 19	54.2 ± 18	NS
Male/female	15/13	18/14	NS
Height, cm	166.2 ± 6.3	165.3 ± 6.2	NS
Weight, kg	58.9 ± 6.1	57.2 ± 5.8	NS
BMI, kg/m^2	21.31 ± 1.95	20.91 ± 1.97	NS
Heart rate, beats/minute	71.3 ± 8.9	72.6 ± 11.5	NS
SBP, mmHg	129.4 ± 12.7	128.1 ± 13.6	NS
DBP, mmHg	76.8 ± 7.1	75.1 ± 7.2	NS
LVEF, %	68.7 ± 7.5	67.9 ± 6.4	NS
RVMD, mm	27.5 ± 2.1	39.4 ± 3.2	< 0.001
RVOTD, mm	25.6 ± 2.3	33.8 ± 2.2	< 0.001
FAC, %	45.2 ± 5.1	31.4 ± 3.3	< 0.001
TAPSE, mm	20.7 ± 1.8	14.1 ± 1.6	< 0.001
S’, cm/s	12.6 ± 1.0	9.0 ± 0.7	< 0.001

BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; LVEF, left ventricular ejection fraction; RVMD, right ventricular middle diameter; RVOTD, right ventricular outflow tract diameter; FAC, fractional area change; TAPSE, tricuspid annular plane systolic excursion; S′, tricuspid annular plane systolic velocity.

Figure 1. Continuous-wave Doppler spectra displaying respiratory variance of TR velocity in a 59-year-old control man. In turn, the spectra of TR velocity, respiratory curve (ascending branch represents the inspiratory phase and the descending branch represents the expiratory phase) and ECG. There is no significant change in the TR velocity between the inspiratory and expiratory phases.

Figure 2. Continuous-wave Doppler spectra displaying respiratory variance of TR velocity in a 64-year-old woman with RV systolic dysfunction. TR velocity in the inspiratory phase decreases significantly compared with that in the expiratory phase.

Table II. Velocity of TR, pressure gradient, and SPAP during the inspiratory or expiratory phase in control and RV systolic dysfunction patients.

	Controls (n = 28)			RV systolic dysfunction (n = 32)
	Velocity of TR (m/s)	Pressure gradient (mmHg)	SPAP (mmHg)	Velocity of TR (m/s)	Pressure gradient (mmHg)	SPAP (mmHg)
Expiration	2.77 ± 0.23	31.09 ± 4.83	35.94 ± 4.96	3.27 ± 0.35	42.51 ± 6.84	53.72 ± 7.39
Inspiration	2.82 ± 0.26	31.4 ± 4.96	36.18 ± 5.12	2.59 ± 0.22	27.01 ± 4.32	38.45 ± 5.63
Change with inspiration	0.05 ± 0.01	0.30 ± 0.03	0.29 ± 0.04	−0.67 ± 0.08	−15.49 ± 3.26	−15.46 ± 3.15
P	0.766	0.478	0.747	< 0.001	< 0.001	< 0.001