Abstract 14831: Right Ventricular Systolic and Diastolic Function by Speckle Tracking Echocardiography - A Novel Approach

Abstract

Background: Because of the complex morphology of the right ventricle (RV), no single imaging plane will provide enough information to evaluate adequately the RV function. Conventional 2D echo is influenced by changes in load, and may not provide robust prognostic information. 2D Speckle Tracking (STE) is accurate and highly feasible, however, normal values of RV strain refers only to the free wall, excluding the contribution of any other RV walls.

Aim: To compare 4C and 2C views for assessing global and regional RV function by STE, in a low-risk, normal population.

Methods: 50 subjects (49±16 years, 30 men) with adequate 4C and 2C RV images were evaluated by STE and conventional echo. We assessed RV systolic function from negative regional (basal, mid, and apical segments) and mean strain, at the level of each wall: lateral (LS), septal (SS), inferior (IS), and anterior (AS); global strain (GS) for 4C and 2C; global systolic strain rate (SRs) from 4C and 2C. Diastolic function was assessed from early and late global positive strain rate (SRe and SRl), separately for 4C and 2C.

Results: LS and SS were significantly different (p<0.001), without differences for AS and IS (table). There was a significant gradient from basal to apical segments only for the lateral and septal walls (both p<0.001). GS, SRs, and SRe were higher in 2C than in 4C view (table). None of the conventional echo parameters correlated significantly with the strain parameters.

Conclusion: Assessment of right ventricular function by STE from the 4C and 2C views do not provide similar information, and they offer complementary data. This might be of particularly clinical interest in diseases with regional RV dysfunction.