Abstract 9966: Right Ventricular Myocardial Strain Evaluated by Two-Dimensional Echocardiographic Speckle Tracking is Strongly Associated with Right Ventricular Contractile Function by Magnetic Resonance Imaging
Purpose:Although the evaluation of right ventricular (RV) function is clinically important in patients with cardiovascular disease, accurate assessment is difficult due to the complexity of anatomy. Two-dimensional speckle tracking echocardiography (2D-STE) permits non-invasive measurement of regional and global RV myocardial strain. The purposes of this study were to investigate the relationship between RV myocardial strain by 2D-STE and RV ejection fraction (RVEF) by magnetic resonance imaging (MRI), and to determine whether RV strain measurement by 2D-STE can detect patients with pulmonary hypertension (PH).
Methods: Fifty-two patients (mean age: 66 ± 10) with cardiovascular disease (ischemic heart disease, n= 10, cardiomyopathy, n= 7, valvular heart disease, n= 19, idiopathic pulmonary hypertension, n= 5, others, n= 11) were studied. RV free wall (RVFW) was divided into three segments on four chamber view (base, mid and apex). Regional and global longitudinal strain of RVFW was measured by using 2D-STE. Cine MRI was acquired in 23 patients by using 1.5T MR scanner, and RVEF was calculated by tracing endocardial border of RV on short axis slices. Right heart catheterization (RHC) was performed in 35 patients, and PH was defined as mean pulmonary arterial pressure (PAP) ≥25mmHg.
Results: The global longitudinal strain of RVFW showed the strongest negative relation with RVEF by cine MRI (r = -0.82, P<0.001). Both regional and global RV longitudinal strains were significantly decreased in patients with PH in comparison to those without (base:-24.1 ± 7.7 vs -17.9 ± 7.3, p=0.02; mid: -22.7 ± 6.0 vs -14.7 ± 6.3, p<0.001; apex: -22.7 ± 5.4 vs -15.7 ± 7.2, p=0.002; global: -22.8 ± 5.5 vs -17.1 ± 6.5, p=0.009). RV longitudinal strain at mid level demonstrates highest correlation with mean PAP by RHC (r=0.71, p<0.001). The area under the ROC curve (AUC) of RV longitudinal strain at mid for the detection of patients with PH was 0.83 (95%CI; 0.69 to 0.98).
Conclusions: RV global longitudinal strain measured by 2D-STE correlates well with RVEF assessed by cine MRI. RV longitudinal strain at mid can detect patients with PH with AUC of 0.83. 2D-STE allows for non-invasive assessment of myocardial strain of RVFW, which is closely related to RV contractile function and PAP.
- © 2011 by American Heart Association, Inc.