Effect of Right Ventricular Pressure versus Volume Overload on Right Ventricular Arterial Coupling Ratio: A 3-Dimensional Echocardiographic Study

Abstract

Abstract Background In congenital heart disease, the RV has been the forgotten chamber for many decades. Congenital ASD leads to volume overload on the RV while PH leads to pressure overload. The 3D ECHO has become noninvasive and readily available method for assessment of the RV-PA coupling ratio by dividing the RV SV/ RV ESV which correlates with the RV function. The aim of our study was to compare that ratio between ASD (RV volume overloaded) patients and PH (RV pressure overloaded) patients . Methods The study included 90 patients divided into 3 equal subgroups; congenital ASD group, PH group and control group. ECG-gated 2D and 3D ECHO study was done to the whole subjects. Results Showed that ASD and PH groups showed statically significant difference as regarding RV volumes and RV-PA coupling ratio in relation to the control group. However, the PH group was affected more than the ASD group as regarding the RV- PA coupling ratio with mean coupling of ASD group was 1.14, 0.77 in PH group and 1.25 in controls with P value between ASD and control groups was 0.054 Vs < 0.0001 between PH and control groups. Conclusion In the current study the RV-PA coupling ratio as measured by 3D ECHO by dividing SV /ESV was markedly reduced (uncoupling) in patient with pressures overload (PH group) and to lesser extent in volume overload (ASD group) compared to the control group.