22
May
Elevated Right Ventricular Systolic Pressure. Pulmonary hypertension occurs when there is abnormally high blood pressure in the pulmonary artery and its branches right sided circulation. A higher systolic value suggests a chronic process with right ventricular hypertrophy. If there is no significant stenosis then the RVSP may be equivalent to the systolic pulmonary artery pressure SPAP. It is based on measuring the TR jet maximum velocity by continuous wave CW spectral Doppler.
The RV systolic pressure ranged from 18 to 55 mm Hg mean 34 - 1 in type A 46 to 55 mm Hg 50 - 1 in type B 60 to 76 mm Hg 66 - 2 in type C and 72 to 118 mm Hg 93 - 7 in type D. An abrupt increase of afterload seen in cases of acute PE event lead to elevated right ventricular wall tension that could result in right ventricular dilatation hypokinesis and secondary tricuspid regurgitation. RVSP was calculated from the peak tricuspid regurgitant jet velocity V using the modified Bernoulli equation RVSP 4V2 RAP with the mean right atrial pressure RAP estimated to be 10 mmHg. 215 Left ventricular pressure. These acute cardiac adaptations caused by acute PE event were summed up as RVD. The tricuspid gradient method provides an accurate and widely applicable method for noninvasive estimation of elevated right ventricular systolic pressures.
Note that the right ventricular wall stress is low in normally functioning ventricles and the right ventricular wall stress is high in those with severe systolic dysfunction.
Acutely the right ventricle is unable to generate a systolic pressure greater than 50 mm Hg. Systemic hypertension occurs when blood pressure is abnormally high in the aorta and its branches left sided circulation. Elevated right ventricle pressure resulting from pulmonary artery stenoses may affect outcome and survival after liver transplantation in patients with Alagille syndrome. An abrupt increase of afterload seen in cases of acute PE event lead to elevated right ventricular wall tension that could result in right ventricular dilatation hypokinesis and secondary tricuspid regurgitation. In common with other types of pulmonary hypertension these changes result in an increased workload for the right side of the heart. These data indicate that the end-systolic configuration of the VS in the short-axis 2-D echocardiogram may be useful for the semiquantitative assessment of the RV systolic pressure.