Correlation of Right Ventricular dP/dt with Functional Capacity and RV Function in Patients with Mitral Stenosis

Background: Evaluation of right ventricular (RV) contractility and systolic function in patients with right sided
heart disease is an essential component of clinical management. The aim of this study was to assess RV systolic
function by qualitative and quantitative methods and compare it to rate of ventricular pressure change during the
isovolumic contraction period (dP/dt) as RV contractility index in patients with rheumatic mitral stenosis.
Patients and Methods: In 56 consecutive patients with moderate to severe mitral stenosis, RV systolic function,
RV dP/dt and dP/dt/Pmax, were calculated and compared.
Results: There was significant correlation between RV dP/dt and RV function (P<0.001) and between RV dP/dt
and New York Heart Association (NYHA) functional capacity (P<.001). The mean of dP/dt was decreased with
increasing severity of RV dysfunction (mean dP/dt was 648±159 for normal RV function, 592± 126 for mild RV
dysfunction, 319±146 for moderate RV dysfunction and 166±150 for severe RV dysfunction) Severity of tricuspid
regurgitation and pulmonary hypertension had no significant effect on RV dP/dt and RV function.
RV dP/dt/Pmax had also significant relationship with RV function and functional capacity (P <0.001).
Conclusion: Measurements of dP/dt and dP/dt/Pmax, are practical methods for estimating RV contractility and
results have a good correlation with RV systolic function and functional capacity.