874 The assessment of right and left ventriclar assynchrony in patients with chronic pulmonary thromboembolism prior and post surgical trombendartherectomy

Background: The pressure overload of the right ventricle (RV) in patients with pulmonary hypertension in the course of chronic pulmonary thromboembolism (CTEPH) alters the mechanical properties of the RV and may result in dyssynchroneous work of both ventricles. Aim: The assessment of changes in synchrony of both ventricles prior and post thrombendartherectomy. Methods: The study group consisted of 7 patients (mean age 50±13 years, 3 male, 4 female) with a diagnosis of CTEPH confirmed by angiography, who had had a surgical thrombendartherectomy. The intraventricular conduction disturbances were not detected neither before nor post operation. Follow up data were collected 1 month post operation: RV diastolic dimension, PV-AcT, RVEF and time form the beginning of QRS till the onset and peak of velocity profile of RV free wall by TDI (respectively RVwall-time to onset, RVwall-time to peak), interventricular septum (IVS-time to onset, IVS-time to peak) and lateral LV wall (LVlat-time to onset, LVlat-time to peak). The intraventricular delay for RV and LV (LVlat-IVS delay; RVwall-IVS delay) and interventricular delay (LVlat-RVwall delay) were calculated. Results: After the endartherectomy NYHA class has changed from 3.2±0.7 to 1.4±0.5, p<0.001; mean pulmonary artery pressure from 51.3±11.7 vs 25±3 mm Hg, p<0.01; total pulmonary resistance from 890±413 to 202±64 dyn/ /cm/s-5, p<0.01. Interand intraventricular delays are shown in the table.