Patients with idiopathic pulmonary arterial hypertension (PAH) have significantly impaired left ventricular strain and intraventricular synchrony, a new study published in the International Journal of Cardiology found.

These measures were associated with known markers of disease severity. Therefore, the authors concluded that left ventricular variables could be an additional prognostic biomarker in idiopathic PAH. 

Patients with idiopathic PAH have normal left ventricular filling pressures. However, the performance of the left ventricle can be affected by the interaction between the right and left ventricles. 

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In the present study, a team of researchers led by Andrew Peacock, MD, from the Scottish Pulmonary Vascular Unit, Golden Jubilee National Hospital in Glasgow, Scotland, assessed left ventricular strain and intraventricular dyssynchrony in patients with idiopathic PAH. They analyzed 70 patients with the disease and 40 healthy controls. 

Read more about the prognosis of PAH

They found no significant differences between patients and controls in terms of left ventricular ejection fraction. However, the left ventricular circumferential and longitudinal strains were lower in patients with idiopathic PAH patients than in controls.

Moreover, the impairment in radial strain was more pronounced in patients with more severe disease than in those with mild disease, and it was associated with the ejection fraction and end-systolic volume index of the right ventricle as well as pulmonary vascular resistance and stroke volume index.

“[Left ventricular] synchrony was impaired in all directions in [idiopathic] PAH,” the researchers wrote. They also calculated that the patient’s age, stroke volume index, pulmonary vascular resistance, left ventricular radial strain, and radial dyssynchrony were independent factors predicting survival.

They concluded that these findings support the practice of examining the function of the left ventricle in patients with pulmonary hypertension. 

PAH is a rare type of pulmonary hypertension characterized by narrowing and thickening of the pulmonary arteries, leading to increased resistance to blood flow. The disease can be heritable, induced by drugs or toxins, associated with other conditions, or idiopathic.


Jayasekera G, Macdonald A, Mccomb C, et al. Left ventricular dysfunction and intra-ventricular dyssynchrony in idiopathic pulmonary arterial hypertension. Int J Cardiol. Published online July 20, 2022. doi:10.1016/j.ijcard.2022.07.032