22 RELATIONSHIP OF RIGHT VENTRICULAR FUNCTION AND EXERCISE TOLERANCE IN PULMONARY ARTERIAL HYPERTENSION


 
 
 Pulmonary arterial hypertension(PAH) is a rarely disease that is characterized by a progressive increase in pulmonary vascular resistance and arterial pressure. The main characteristic of pulmonary hypertension(PH) is exercise intolerance and determination of exercise capacity has an important role in the evaluation of patients.
 
 
 
 The purpose of our study is to explore the relationship of right ventricular dysfunction(RVD) and poor exercise tolerance.
 
 
 
 Patients with PAH were prospectively enrolled from 2018 to 2021 at baseline assessment in the PH center. RVD was defined as Tricuspid Annular Plane Systolic Excursion (TAPSE)<17 mm in apical four chamber view. Patients were divided in two subgroups according to the presence or absence of RVD. Finally, all subjects underwent exercise tolerance evaluation with six minute walking test (6MWT). All evaluation were made according to current guidelines.
 
 
 
 A total of 33 PAH patients (66,33±12,74 years; 42% male) were included in the study. Most frequent comorbidities were dyslipidemia(n=15;44%), diabetes(n=7;20%), hypertension(n=23;67%). Concerning echocardiographyc evaluation, mean Left Ventricular Ejection Fraction (LVEF), PAPs and TAPSE was 56,64±5,37%, 57,88±25,85 mmHg, 20,93±5,20 respectively. Mean 6MWT was 318,91±11,61 meters. When compared patients with RVD with those without, a higher prevalence of atrial fibrillation/atrial flutter was observed (n=5, 62%; p 0,013) and statistically significant differences of right ventricular basal diameter (p 0,012), right atrial area (p 0,002), LVEF (p 0,015) and 6MWT (p 0,008) were detected. In the overall population a statistically significant linear regression was observed between RVD and 6MWT (p 0,029).
 
 
 
 RVD is a predictor of poor functional capacity as assessed with 6MWT in patients with PAH at baseline.
