Background: The role of the Right Ventricle (RV) has been largely underestimated compared to left ventricle in cardiac diseases. Nowadays the importance of RV has been recognized as independent risk factor for mortality in heart failure. Elevated mean Pulmonary Arterial Pressure (mPAP) is also a recognized independent predictor in heart failure patients. There is a scarcity of data evaluating this relationship in heart failure patients in sub-Sahara Africa. This study was therefore designed to establish the relationship between RV systolic function, Left ventricular ejection fraction and mPAP in hypertensive heart failure patients in Obafemi Awolowo university teaching hospitals complex.
Methodology: Eighty patients with heart failure secondary to hypertension and 80 normal controls underwent clinical, electrocardiographic and echocardiographic evaluation. Indices of right ventricular systolic function that were measured include Tricuspid Annular Plane Systolic Excursion (TAPSE), and Right Ventricular Myocardial Performance Index (RVMPI) and mPAP was derived from RV outflow tract acceleration time after pulse interrogation at level of pulmonary valve.
Results: forty two (52.5%) and 22 (27.5%) heart failure patients had right ventricular systolic dysfunction and right ventricular global dysfunction respectively as measured by TAPSE and RVMPI. Elevated mean pulmonary artery pressure was found in 38 (47.5%) of the hypertensive heart failure patients. There was no relationship between the indices of right ventricular systolic function and the estimated mean pulmonary artery pressures. There were also no significant relationships between left ventricular ejection fraction and estimated mPAP. The independent predictor of right ventricular systolic dysfunction was the LV ejection fraction.
Conclusion: Right ventricular systolic function is impaired in patients with heart failure secondary to hypertensive heart disease. There is no relationship between the indices of right ventricular systolic function and mean pulmonary artery pressure. Further studies are needed to assess right ventricular systolic function in Nigerians.