The presence of early diastolic dip of ventricular septum has been reported to be able to accurately diagnose occult cor pulmonale during cycle ergometer exercise test in patients with chronic obstructive pulmonary disease (COPD). The study was conducted to test the ability of dobtamine stress echocardiography (DSE) to detect cases of occult cor pulmonale among patients with schistosomal hepatic fibrosis and congestive splenomegaly. The study include 25 patients aged 35.6±12.7 years with schistosomal hepatic fibrosis and congestive splenomegaly (group 1:15 males and 10 female) compared to 25 aged sex-matched patient with COPD (group ІІ). M mode echocardiographic ventricular septal motion, left ventricular shape (determined by short axis 2 dimentional echocardiography), and pulmonary artery (PA) acceleration time (determined by pulse Doppler echocardiography). Were measured at rest and during DSE. The ventricular septal motion and PA acceleration time were normal at rest in all patients. In group І: 22 patients (88%) reported marked downword ventricular septal motion in early diastole during DSE. Indicating distortion of left ventricular shape. In group II only (11 patients 44%) showed the same change during DSE. There is significant decrease in PA acceleration time in patients who showed septal dip in both groups from rest to DES. It could be concluded that occult cor pulmonale can be diagnosed by the appearance of early diastolic dip of the ventricular septum and distorted left ventricular shape during DSE in patients with schistosomal hepatic fibrosis and congestive splenomegaly and COPD patients. This method may be useful in selecting cases for medical treatment for early cor pulmonale |
