Abstract 11360: Three Dimensional Speckle Tracking Strain Evaluation of Right Ventricular Mechanics in Patients with Pulmonary Arterial Hypertension
Background: Assessment of right ventricular (RV) mechanical function in patients with pulmonary arterial hypertension (PAH) is clinically important but challenging using current 2-dimensional (2D) methods.
Objective: Our aim was to use the novel approach of 3-dimensional (3D) speckle tracking strain echocardiography to assess RV mechanics in patients with chronic PAH.
Methods: We studied 40 subjects prospectively: 25 patients with chronic PAH (aged 60±15 years) and 15 normal controls. Routine echo RV parameters included tricuspid annular plane systolic excursion (TAPSE), RV area and RV fractional area change. 3D speckle tracking strain echocardiography was used to assess global area tracking strain, maximum time delay to peak strain, and standard deviation of the time to peak strain in RV wall.
Results: Compared to normal subjects, PAH patients had statistically different TAPSE (16±3 vs. 25±3 mm, p<0.0001), RV end-diastolic area (25±8 vs. 19±4 cm2, p<0.01), RV end-systolic areas (18±8 vs. 10±3 cm2, p<0.0005), and RV fractional area change (29±10 vs. 44±7 %, p<0.0001). Using 3D speckle tracking, RV global area tracking strain, maximum time delay to peak strain, and standard deviation were all significantly different than normal control consistent with regional dyssynchrony associated with diminished RV function (22±6 vs. 31±4 %, p<0.0001; 471±211 vs. 256±171 ms, p<0.005; 121±47 vs. 65±34 ms, p<0.0005; respectively). RV global area tracking strain correlated significantly with RV fractional area change: r =0.66, p<0.0001.
Conclusion: 3D speckle tracking strain echocardiography in a new technique to assess RV mechanical function in patients with PAH. Global area tracking strain correlated with routine echo measures, and added unique 3D time-to-peak strain data, which are not possible by 2D methods. 3D strain appears to be a promising new method for quantitative assessment of RV function in PAH.
- © 2011 by American Heart Association, Inc.