Doppler echo evaluation of right ventricular function after lung transplantation in pulmonary hypertension patients

It is important to restore right ventricular (RV) function after lung transplantation (TX) in pulmonary hypertension (PH) patients. This study was designed to study RV systolic and diastolic function before (Pre) and at 1-3 months (Post-1) and 1-2 years (Post-2) after TX. 2D and Doppler echo was performed in nine patients (primary PH, n=6; secondary PH, n=3) with a mean RV systolic pressure (RVSP) of 90 mmHg. Controls were 9 age-matched normals (NL). RVSP was calculated from a peak tricuspid regurgitant velocity by CW Doppler. RV systolic time (pre-ejection time/ejection time, STI) and pulmonary acceleration time (Accl T) were measured from pulmonary arterial flow at the short axis view. RV isovolumic relaxation time (IVRT) was determined as a time difference between heart rate (HR) matched tricuspid inflow and pulmonary outflow Doppler PW recordings. Tricuspid annulus diameter as an index of RV size (RVd) was also obtained from apical 4-chamber view during end-diastole. Result: HR RVSP STI Accl T (ms) IVRT(ms) RVd(cm) Pre-TX 87±15 90±12 .61±.12 51±24 126±34 5.4±.08 Post-1 89±12 34±11*.48±.05*91±17*88±15*3. 7+.05*Post-2 81±12 32±8**.46±.07**98±10* *89±33**3.8±.08**NL 80±13 .38±.04a 110±19 51±8a 3.1±.03a*p<0.05, Post-1 vs Pre;**p<0.05, Post-2 vs Pre; a p<0.05, NL vs Post-2 Conclusions: 1) Doppler echo parameters for RV systolic and diastolic function dramatically improve shortly after TX. 2) One year later the improvement maintains, although RV function has not been totally restored.