Myocardial Tissue Doppler-Based Indexes to Distinguish Right Ventricular Volume Overload from Right Ventricular Pressure Overload

Shih Hung Hsiao, Wen Chin Wang, Shu Hsin Yang, Chiu Yen Lee, Shu Mei Chang, Shih Kai Lin, Kuan Rau Chiou

Research output: Contribution to journalArticle

15 Citations (Scopus)


The objective of this study was to develop tissue Doppler parameters that could be used to differentiate right ventricular (RV) volume overload from RV pressure overload. The RV-pressure-overload group consisted of 40 patients with severe pulmonary hypertension, and the RV-volume-overload group consisted of 40 patients who had an atrial septal defect without evidence of right-to-left shunt, significant pulmonary hypertension, or Eisenmenger's complex. Another 40 healthy subjects were enrolled and served as a control group. Routine echocardiography and tissue Doppler imaging were performed. RV myocardial performance index was determined based on data collected during tissue Doppler imaging over the lateral tricuspid annulus. In patients with RV pressure overload, tissue Doppler parameters showed characteristically lower systolic velocity over the tricuspid annulus (RV myocardial systolic wave [Sm]) and longer isovolumic relaxation time (RV-IVRT). Nevertheless, in patients with RV volume overload, RV-Sm increased significantly, but early-diastolic velocity over tricuspid annulus was relatively low. In conclusion, RV-MPI, RV-Sm/early-diastolic velocity over tricuspid annulus, and RV-IVRT/RV-Sm were all useful to differentiate RV pressure overload from volume overload, although RV-IVRT/RV-Sm was the best parameter, with excellent sensitivity and specificity.

Original languageEnglish
Pages (from-to)536-541
Number of pages6
JournalAmerican Journal of Cardiology
Issue number4
Publication statusPublished - Feb 15 2008
Externally publishedYes


ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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