Abstract 12049: Longitudinal Strain Curves of the Right Ventricular Free Wall Differ in Morphology in Patients with Pulmonary Hypertension Compared to Controls
Purpose. Right ventricular (RV) function is an important determinant of clinical status and prognosis of patients with pulmonary hypertension (PH). Therefore, central to the management of those patients is an accurate measurement of RV function. Previous studies that have used speckle tracking-derived strain for quantification of RV function have focused on magnitude of global and regional peak longitudinal systolic strain (PLSS) and systolic strain-related indices of dyssynchrony. Aim of our study was to investigate whether the contour of strain curves described by the time to PLSS (SST) and the time from PLSS to 50% of PLSS (systolic strain half time-SSHT) differ between patients with PH and controls.
Methods. Twenty five patients with PH (15 with pulmonary arterial hypertension and 10 with left-sided valvular heart disease) without right bundle branch block (mean age 45 +/- 18 years, 13 women) and 20 normal subjects (mean age 42+/- 15 years, 5 women) were evaluated. A complete two-dimensional echo with speckle-tracking-derived longitudinal strain of the basal right ventricular free wall and interventricular septum was performed and the cycle length-corrected SST and SSHT intervals in both regions were calculated.
Results. Patients with PH had significantly reduced PLSS (-24.9±2.0% vs -43.2±3.0 %, p<0.001) and increased SST (0.47±0.02 vs 0.39±0.02, p=0.043) and SSHT (0.22±0.02 vs 0.16±0.02, p=0.047) at the basal RV free wall compared with controls. There was no statistically significant difference between patients and controls regarding PLSS (-15.4±2.0% vs -14.7±2.7 %, p=843), SST and SSHT at the interventricular septum. No significant correlations were found between SST or SSHT and PLSS, as well as between SST or SSHT and RV systolic pressure.
Conclusions. Longitudinal strain curves in the RV free wall differ in morphology in patients with PH compared with controls reaching peak values later in the cardiac cycle and returning slower towards baseline. Therefore, they can effectively illustrate changes in RV contraction and relaxation caused by PH.
- © 2011 by American Heart Association, Inc.