Arq. Bras. Cardiol. 2019; 112(3): 258-259

Let’s Look Right during Diastolic Dysfunction Evaluation?

Murilo Foppa , Angela Barreto Santiago Santos

DOI: 10.5935/abc.20190053

This Short Editorial is referred by the Research article "Echocardiographic Correlation between Right Ventricular Function and Left Atrial Volume".

Nearly half of heart failure patients have preserved ejection fraction (HFPEF). HFPEF is traditionally attributed to an increased left ventricular end-diastolic filling pressure (Pd2), triggered by structural, metabolic and functional mechanisms. Echocardiography permits to identify HFPEF signs as diastolic dysfunction (DD), enlarged left atrium, and more subtle abnormalities of systolic function detected by global longitudinal strain.^, Right ventricular (RV) abnormalities and pulmonary hypertension are also identified by echocardiography and are frequently seen in HFPEF. However, there are controversies if the abnormalities seen in right cardiac chambers are a consequence of left-sided abnormalities or if they correspond to a direct effect over left and right chambers simultaneously, caused by the same mechanisms, such as diffuse subendocardial fibrosis and subclinical systolic dysfunction.

In this journal, Baroncini et al. sought to bring more evidence to fill this knowledge gap. The authors compared two small samples of individuals with and without DD (25 subjects in each group) and found no significant changes in RV function between the groups measured by tricuspid annular plane excursion (TAPSE) or RV free wall systolic velocity (s’). The secondary analysis highlighted by the authors showed that in the subgroup with DD, the 7 individuals with a dilated left atrium presented worse RV function parameters compared to the other patients with DD (n = 18). These results could suggest that RV abnormalities would be present only in those already with a chronic increase in left atrial pressure identified by its dilatation.

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