Abstract 11336: Comprehensive Assessment of Right Ventricular Function in Patients With Pulmonary Hypertension With Global Longitudinal Peak Systolic Strain Derived From Multiple RV Views
Objectives: To determine the utility of regional and global right ventricular longitudinal strain (RVLS) calculated from multiple views of the right ventricle (RV) to comprehensively assess RV function in a cohort of PH patients.
Background: RV function is a strong predictor of mortality in pulmonary hypertension (PH), but 2D echo-derived assessments of RV function that could aid in risk assessment and management of patients with PH are of limited utility. RVLS derived from 2D speckle-tracking echocardiography (2DSTE) is a relatively novel method for quantifying RV function but typically is derived from a single apical 4 chamber view of the RV and thus has inherent limitations.
Methods: Regional and global RVLS were obtained from multiple views of the right ventricle (centered on the RV-focused apical position, with three 60 degree planes based on the apical 4 chamber view) in 40 patients with pulmonary hypertension (PH), defined as a mean PA pressure > 25 mmHg, with a pulmonary vascular resistance (PVR) > 3 WU (primarily WHO group 1 pulmonary arterial hypertension (PAH) patients) and was compared to other 2D echo-derived parameters of RV function in 40 control subjects.
Results: Global RVLS calculated from multiple views has a superior correlation with six minute walk distance (6MWD) than other parameters of RV function including tricuspid annular plane systolic excursion (TAPSE), RV index of myocardial performance (RIMP) and fractional area change (FAC). While global RVLS calculated from multiple views displayed a similar correlation with 6MWD as global RVLS calculated from a single 4 chamber view, analysis of regional strains provided by multiple views identified distinct patterns of RV dysfunction, consisting either of global, free wall or septal dysfunction, that were associated with specific clinical characteristics.
Conclusions: Global RVLS derived from multiple RV-focused views yields a comprehensive quantitative assessment of regional and global RV function that correlates well with functional parameters and may be useful in the assessment of PH. Distinct patterns of regional RV dysfunction are associated with different clinical characteristics.
- © 2013 by American Heart Association, Inc.