Cardiac structure and function in chronic thromboembolic pulmonary hypertension.

The observations made on patients with chronic TE-PH conform with the work of others who have shown marked right-sided cardiac chamber enlargement and abnormal left-sided diastolic function in patients with other forms of PH and RV pressure overload. The unique results from our patient population are a consequence of the reversal of these structural and functional abnormalities early after surgical treatment of the PH. The reversal of these abnormalities, including normalization of RV function, is extremely important when considering forms of therapy such as isolated lung transplantation, where a failure of RV function to normalize would be catastrophic. Although echocardiography is currently limited by its data acquisition in two dimensions, the results concerning measurements of area and length, rather than volume, are convincing. It is anticipated that future application with techniques such as three-dimensional reconstruction of echocardiographic images will allow an even more thorough evaluation of the cardiac structural and functional changes in patients with thromboembolic pulmonary hypertension.