Effect of Age, Heart Rate and Tricuspid Regurgitation on the Doppler Echocardiographic Evaluation of Right Ventricular Diastolic Function

Abstract

Pulsed-wave Doppler analysis of tricuspid inflow and hepatic venous flow allows the determination of multiple parameters of right-ventricular (RV) diastolic function. This study sought to evaluate the influence of heart rate, age and tricuspid regurgitation on Doppler parameters of RV diastolic performance. We studied 80 subjects (20 normal and 60 with RV pathology) with Doppler recordings of the tricuspid inflow and hepatic vein. All tricuspid Doppler parameters were dependent on heart rate, age or regurgitation severity as were the hepatic vein S wave, S/D ratio and systolic filling fraction. The atrial reversal velocity in the hepatic vein Doppler tracing was not affected by age, heart rate or regurgitation. In addition, the inspiratory increase in this parameter was significantly elevated in RV pathologic states. This study demonstrates that most Doppler echocardiographic parameters of RV diastolic performance are dependent on age, tricuspid regurgitation or heart rate.

Effects of age and pulmonary arterial hypertension on the different phases of right atrial function

“…Our observation of a redistribution of right atrial emptying with a greater dependence on booster pump function in healthy subjects C60 years is consistent with other studies that have shown a larger contribution of atrial contraction to right ventricular filling with age using conventional Doppler of transtricuspid and hepatic vein flow [11][12][13][14]. Our findings are also consistent with recent tissue Doppler imaging studies [3,13].…”

“…This increases late left ventricular filling and pressure and maintains cardiac output [4]. Since there is also a decline in right ventricular diastolic function with age [11][12][13][14] and pulmonary arterial hypertension [16], it is tempting to speculate that similar mechanisms occur in the right sided cardiac chambers [16].…”

“…These investigations have reported that the relative contribution of the components of phasic left atrial function to left ventricular filling are affected by several factors including age, [2][3][4][5] hypertension [6][7] and left ventricular dysfunction [8][9][10]. A smaller number of studies, primarily using conventional or tissue Doppler imaging, have shown that right atrial active emptying is also affected by some of these factors with an increase in right atrial pump function reported in the elderly [3,[11][12][13][14] and pulmonary arterial hypertension patients [15][16]. Another study used acoustic quantification to measure right atrial areas continously during the cardiac cycle and evaluate both the passive and active phases of right atrial emptying.…”

Cardiac Status after Childhood Growth Hormone Treatment of Turner Syndrome

“…Previously Radetti et al (8) reported comparable findings in TS during GH treatment. Diastolic filling is known to be heart rate dependent (25,26), and correction for heart rate (which was significantly higher in our patients) resulted in comparable biventricular diastolic filling pattern between our patients and controls. As Radetti et al previously suggested, the changes seen in LV diastolic filling in TS probably should be regarded as an adaptation to the higher heart rates seen in TS, rather than an early representation of LV dysfunction (8).…”

Right Atrial Size Relates to Right Ventricular End-Diastolic Pressure in an Adult Population with Congenital Heart Disease

“…Multiple Doppler‐derived echocardiographic parameters have been suggested to assess RV diastolic function: tricuspid E/A ratio, 4,5 early diastolic tricuspid annular velocity (Em), 6–8 RV annulus Em/Am, 8,9 E/Em, 10 RV MPI and IVRT, 8,11 and negative dP/dT 12 . However, most of these parameters have been limited by their sensitivity to respiratory alterations in preload and afterload, age, tricuspid regurgitation and heart rate 13–15 …”