Comparison of vectorcardiographic parameters with structural-functional state of the right ventricle in patients with pulmonary hypertension

Changes of the vectrocardiographic ventricular gradient (VG) in patients with pulmonary arterial hypertension (PAH) are indicative of right ventricular (RV) overload and may be used to assess its severity. The study aim was to evaluate interrelations between vectrocardiographic VG, spatial QRS-T angle and echocardiographic parameters of structural-functional state of the RV.The following parameters were assessed in 30 PAH patients: RV dimensions; tricuspid annular plane systolic excursion (TAPSE); RV fractional area change (FAC); RV peak systolic annular velocity (TDI-S’), and longitudinal strain (LS). VG and spatial QRS-T angle were calculated using the orthogonal leads derived from standard echocardiography.Spatial component VG-Y had moderate negative correlation with LS (r=-0.62; p <0.005); VG magnitude, VG-X and VG-Y had positive correlations with FAC (r from 0.50 to 0.65; p <0.005); VG magnitude and VG-Y had positive correlations with TDI-S’ (0.58 and 0.53; p <0.005); spatial QRS-T angle had negative correlation with TAPSE (r=-0.59; p <0.005), FAC (r=-0.66; p <0.005) and TDI-S’ (r=-0.67); p <0.005.In patients with severe PAH, VG and spatial QRS-T angle correlate not only with RV dimensions and pulmonary artery pressure, but with parameters of RV systolic function.

vectorcardiography, ventricular gradient, echocardiography, right ventricular systolic function

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