Evaluation of pulmonary artery stiffness and right ventricular functions by transthoracic echocardiography in polycythemia vera patients

In this study, it was aimed to evaluate right ventricular functions and pulmonary artery stiffness in polycythemia vera patients and compare them wih healthy controls. A group of 47 polycythemia vera patients and 40 healty controls, aged 18-75 years, who met the inclusion and exclusion criteria of the study, were included in the study. Socio-demographic characteristics of both groups were examined. In conventional echocardiographic examination, right and left ventricular systolic and diastolic diameters, right ventricular myocardial performance index, right ventricular diastolic functions, estimated systolic pulmonary artery pressure, pulmonary artery stiffness were evaluated. Right ventricular diastolic and systolic volumes, right ventricular ejection fraction, tricuspid annular plane systolic displacement and right ventricular fractional area change were evaluated with 3D echocardiography. Right ventricular global strain was evaluated by strain echocardiography. In addition, the relationship of all these parameters with pulmonary artery stiffness was investigated. Pulmonary artery stiffness values of patients followed up with polycythemia vera were higher than controls, but estimated systolic pulmonary artery pressure values were similar between groups. Right ventricular myocardial performance index, one of the right ventricular systolic function markers, was higher in polycythemia vera patients than in controls. In addition, right ventricular global strain evaluated by strain echocardiography and right ventricular ejection fraction, tricuspid annular plane systolic displacement and right ventricular fractional area change obtained by 3D echocardiograpy were lower in the polycythemia vera group than in the control group. There was a possitive correlation between pulmonary artery stiffness and disease duration, estimated systolic pulmonart artery presssure and right ventricular myocardial performance index, and a negative correlation between right ventricular ejection fraction, tricuspid annular plane systolic displacement and right ventricular fractional area change, and isovolumetric acceleration time. In addition, disease duration, estimated systolic pulmonary artery pressure, right ventricular myocardial performance index, right ventricular ejection fraction, and right ventricular fractional area change were found to be independent predictors of pulmonary artery stiffness. Patients with polycythemia vera may have subclinical right ventricular dysfunction and pulmonary artery stiffness value can be used in the early diagnosis of pulmonary hypertension and right ventricular dysfunction in this patient group.