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Various factors may influence the presence and severity of D-LV. For example, excess weight on LV diastolic dysfunction10) and RV dysfunction11) have been documented. Moreover, obesity was associated with decreased functional capacity in patients with PH.12) As cardiac and pulmonary diseases increase with aging, the prevalence of PH also increases. Previous data have shown that, although PH was once thought to affect young adults, the mean age of patients with PH now represents a growing proportion of older patients.13) In our study population, there was no difference in BMI between groups, and patients with D-LV were younger than other patients. Although age and BMI may affect PAP, D-LV was not simply determined by PAP but may be determined by interactions between LV and RV hemodynamics.

The presence of an anechoic space within the pericardium, right atrial inversion or right ventricular diastolic collapse indicates pericardial effusion. These measurements using HCU can specifically predict pericardial effusions [14, 18, 33]. One limitation includes epicardial fat being misinterpreted as an effusion, especially when the operator is less experienced. Assessing respiratory variation of the mitral or tricuspid inflow velocities and the aortic flow velocity is limited to pulse-wave Doppler probes. Few HCU devices can offer this function whilst TTE routinely examines these entities allowing for quantitative assessment of pericardial disease. Assessment for pericardial fluid or tamponade in patients with myocardial infarction, myocarditis and pericarditis are important to guide investigation, therapy and discharge planning. 2b1af7f3a8

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