الفهرس 
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Abstract
Pulmonary hypertension characterized by increased pressure load on the right ventricle (RV) that subsequently results in the normal adaptive response of hypertrophy and dilation. Right ventricular failure occurs when the ventricle is unable to respond further to the hemodynamic burden.. Also left ventricle undergoes remodeling in response to chronic pressure overload on the right ventricle that may be functional and or structural remodeling. Increase in left ventricular mass defines left ventricular hypertrophy. Left ventricular hypertrophy is common and occurs in various pathologies. We aim to assess left ventricular mass changes in patients with pulmonary hypertension. The study involved two groups: group A: (40) patients with pulmonary hypertension ( PASP more than 40 mmHg) of any group except group 2 which represent PHT due to cardiac causes and normal LV systolic function (EF ≥ 50%).Most of them are chronic obstructive pulmonary disease . We excluded patients with significant mitral or aortic valve disease, myocardial disease as HCM, pericardial disease, coronary artery disease, LV systolic dysfunction, systemic hypertension and bad echogenic window. group B: (20) age and sex matched healthy volunteers represented the control group. All patients included in the study were subjected to full history taking, thorough clinical examination, 12-leads surface ECG, echocardiographic examination by M-Mode in parasternal long axis view to measure left atrial diameter, aortic root diameter, left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), interventricular septum thickness at end diastole (IVSTd),posterior wall thickness at end diastole (PWTd) and assessment of LV systolic function (Fractional shortening and ejection fraction). LV Mass was calculated using the Devereux formula. Left ventricular mass was indexed to body surface area .Right ventricular anterior wall thickness in parasternal long axis view was measured by M mode at tip of mitral valve at end of diastole. 2D echocardiographic study to assess right ventricular dimensions including right ventricular longitudinal diameter (RVLAX), right ventricle mid cavitary and basal transverse diameters during diastole. Doppler study by trans-mitral doppler to measure peak of E (early diastolic) wave velocity and peak of A (late diastolic) wave velocity and E/A ratio .Doppler ultrasound to estimate the pulmonary artery systolic pressure. Results Demographic characteristics of the studied groups showed that there was a significant difference between cases and controls as regard body mass index( BMI) (34.0 ± 8.5 vs27.6 ± 2.2) .Our patients were more obese than controls, but there was no significant difference between cases and controls as regard age, gender and smoking . We found that RV anterior wall thickness and each of right ventricle mid cavitary and basal RV transverse diameters during diastole were significantly higher in cases than controls(7 ± 2 vs 4 ± 1) (34 ± 7 vs 29 ± 3) (38 ± 8 vs 33 ± 2) respectively (P-value < 0.001) .Similarly Septal wall thickness and posterior wall thickness were significantly higher in cases than controls (10 ± 2 vs8 ± 1) (10 ± 2 vs8 ± 1 ) (P-value < 0.001) respectively.
posterior wall thickness at end diastole (PWTd) and assessment of LV systolic function (Fractional shortening and ejection fraction). LV Mass was calculated using the Devereux formula. Left ventricular mass was indexed to body surface area .Right ventricular anterior wall thickness in parasternal long axis view was measured by M mode at tip of mitral valve at end of diastole. 2D echocardiographic study to assess right ventricular dimensions including right ventricular longitudinal diameter (RVLAX), right ventricle mid cavitary and basal transverse diameters during diastole. Doppler study by trans-mitral doppler to measure peak of E (early diastolic) wave velocity and peak of A (late diastolic) wave velocity and E/A ratio .Doppler ultrasound to estimate the pulmonary artery systolic pressure. Results Demographic characteristics of the studied groups showed that there was a significant difference between cases and controls as regard body mass index( BMI) (34.0 ± 8.5 vs27.6 ± 2.2) .Our patients were more obese than controls, but there was no significant difference between cases and controls as regard age, gender and smoking . We found that RV anterior wall thickness and each of right ventricle mid cavitary and basal RV transverse diameters during diastole were significantly higher in cases than controls(7 ± 2 vs 4 ± 1) (34 ± 7 vs 29 ± 3) (38 ± 8 vs 33 ± 2) respectively (P-value < 0.001) .Similarly Septal wall thickness and posterior wall thickness were significantly higher in cases than controls (10 ± 2 vs8 ± 1) (10 ± 2 vs8 ± 1 ) (P-value < 0.001) respectively.