Study Participants and Methods
We included 84 healthy subjects, aged between 30 and 50, in our study.
After an announcement in our hospital, this group was recruited from
medical students, medical residents, and clinical and non-clinical
hospital personnel. Each person signed a detailed written informed
consent before enrollment in the investigation. The study was in
accordance with the Declaration of Helsinki. After comprehensive history
taking and physical examination, an electrocardiography (ECG) was
acquired and detailed echocardiography was performed based on the latest
guidelines for performing a comprehensive transthoracic
echocardiographic examination in adults1. Exclusion
criteria were any of the coronary artery disease risk factors including
: diabetes, hyperlipidemia, hypertension, cigarette smoking), history of
cardiac or pulmonary diseases, any signs or symptoms in favor of
cardiac, pulmonary, or thyroid diseases, ECG abnormalities (including
bradycardia, tachycardia, axis deviation or bundle branch blocks and any
ST-T changes) or any echocardiographic abnormalities in chamber sizes or
function and cardiac valves. Participants with mild valvular
regurgitations in echocardiography were not excluded.
Echocardiography was done in the left lateral decubitus position with
the ”Vivid S5 GE” vendor. All echocardiographic measurements were done
in offline mode by an expert echocardiography fellowship. In the
RV-focused view, the M-mode cursor was aligned with the lateral
tricuspid annulus. The distance between early systole and end-systolic
excursion of RV free wall was measured in centimeters (cm). Color-coded
M-mode was used to better delineate the peak systole of the RV free
wall. Systolic time (TAPSE-t) was also measured in the exact tracing by
measuring the time from the initial QRS to the maximum systolic
excursion (Figure A, B)