الفهرس 
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Abstract
Pulmonary hypertension is a serious clinical condition
which is known to be progressive and to result in significant
damage to the right heart function. Pulmonary hypertension
which imposes pressure overload on the right ventricle, through
elevated pulmonary artery pressure can cause premature death in
severe cases (106) .It is known that long standing and severe
Pulmonary hypertension can result in intractable and potentially
irreversible right ventricle damage, even after lung transplantation
(107).
Off-line analysis of the RV apical 4-chamber view by
speckle tracking echocardiography (STE) for 2D strain and strain
rate measurements was made using the commercially available
EchoPac analysis system (GE, version 8.0.1, US). The software is
based on real time tracking of natural acoustic markers, present in
the ultrasound tissue images, which allows the derivation of 2D
strain and strain rate (frame rate = 50 - 54 f/s) by comparing
displacement of speckles in relation to one another throughout the
cardiac cycle.
The inflow compartment of the RV consists of the lateral
free wall and septum. The endocardial border of the RV inflow
and outflow tract were manually traced and tracked by the
software in order to determine the RV longitudinal displacement measured. Strain and strain rate values were measured to RV free
wall, and septal walls.
Results of the current study showed that:
Demographic and clinical data:
· Age:
The mean age for group I (Pulmonary arterial
hypertension) was 57.05 ± 10.94 years , and the mean age for
group II (control group) was 43.65 ± 9.49 years.There was
significant difference between the 2 groups (I &II) as regard
age(p-value <0.001).
· clinical data:
There was significant difference between the two groups as
regard DM and HTN (p- value< 0.001) .
Tricuspid valve Regurge Gradient, Pulmonary artery systolic
pressure and Tricuspid annular plane systolic excursion:
Group I (cases) have significant increaseaed TR gradient
and PASP and depressed TAPSE compared to group II (control).
RV STRAIN
Average right ventricular (septal and lateral walls) peak
longitudinal systolic strain (S%) were significantly depressed in Correlation between PASP with TAPSE,RV Strain (septal &
lateral walls) and RV Strain Rate in Systole, Early and late
diastole (septum &lateral wall):
There was significant negative correlation between
pulmonary artery systolic pressure and Tricuspid annular plane
systolic excursion , average RV Strain and strain rate [septal and
lateral walls] (TAPSE ,RV Strain and strain rate are depressed
with increasing PASP).