الفهرس 
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Abstract
Pulmonary hypertension is a serious disease often accompanied with right
ventricular (RV)dysfunction and failure, survival in patients with pulmonary
hypertension is strongly related to RV function.( Voigt JU et al.2014)
The total pulmonary hypertension burden is substantial as it represents the end stage of multiple disease processes such as left sided heart disease, chronic lung disease ,as well as pulmonary arterial hypertension(PAH) which is very rare( Galie Net al.2015), most of the patients who are diagnosed with PH on routine testing (echocardiogram with pulmonary arterial systolic pressure PASP>46 mmHg) will end up having left heartdisease(nearly 80%) some with lung disease and hypoxia (about 10%) and only a small minority (4%) will have PAH.(Fine NM et al.2013)
Although pulmonary hypertension is defined by normal left ventricular (LV) filling pressuresLV performance may be affected because both ventricles share in the ventricular septum within the same pericardial sac (PuwanantS et al.2010) , progressive pressure load leads to bowing of the septum towards the left ventricle therefore disturbing the LV geometry and impairing LV filling in addition .