Prolonged Right Ventricular Post-Systolic Isovolumic Period in Pulmonary Arterial Hypertension: A Reflection of Diastolic Dysfunction?

Gert Jan Mauritz¹, J. Tim Marcus¹, Nico Westerhof¹, Pieter E. Postmus¹, Anton Vonk Noordegraaf¹

In PAH a prolonged time interval between pulmonary valve closure and tricuspid valve opening is observed. This period is assumed to measure a prolonged right ventricular (RV) relaxation, and to reflect diastolic dysfunction. In this study it was shown that this period is the consequence of a prolonged contraction of the RV free wall which continues after pulmonary valve closure causing a post-systolic contraction. In contrast the RV isovolumic relaxation period is not increased. Therefore, in clinical practice the isovolumic period between pulmonary valve closure and tricuspid valve opening is not a real measure of diastolic dysfunction in PAH patients.