Abstract 13690: Longitudinal and Segmental Right Ventricular Free-Wall Strain Before and After Pulmonary Thromboendarterectomy in Patients With Chronic Thromboembolic Pulmonary Hypertension
Introduction: Echocardiographic assessment of right ventricular (RV) function is problematic. We sought to evaluate RV systolic function in chronic thromboembolic pulmonary hypertension (CTEPH) using 2D speckle tracking and strain analysis. We assessed longitudinal & segmental RV free-wall strain before and after pulmonary thromboendarterectomy (PTE) in patients with CTEPH.
Hypothesis: We hypothesized systolic strain would improve after PTE.
Methods: Peak systolic strain (%) of the RV free-wall and its segments (basal, mid, apical) was measured by 2D echocardiography in 127 consecutive CTEPH patients (52 ± 14 years, 49% female) with adequate images pre- & post- PTE. Strain was measured 9.7 ± 17.3 days pre- and 11.3 ± 17.0 days post-PTE using Epsilon Imaging EchoInsight software.
Results: Mean longitudinal strain of the RV remained the same pre-PTE compared to post-PTE (-11.4 ± 5.7 to 11.2 ± 5.6%, p = 0.67), but basal & mid RV free-wall strain worsened (less negative): -17.1% to -14.1% (p=0.003) and -12.8% to -10% (p=0.001) respectively after PTE. Apical RV free-wall strain improved (more negative): -3.7% to -9.2% (p<0.001) (Table 1). Pre-PTE, mean RV free-wall strain correlated significantly with pulmonary vascular resistance (PVR) (Table 2) and mean pulmonary artery pressure (mPAP), but this relationship disappeared after PTE.
Conclusions: RV free wall basal and mid segment systolic strain worsened (less negative) soon after PTE, while the apical segment strain improved (more negative). The reasons for these differences are unclear, but may vary due to RV stunning and changes in LV filling. RV mean free-wall strain correlates significantly with PVR pre- but not post-PTE.
Author Disclosures: D. Wong: None. O. Yousefian: None. W. Auger: None. T. Dittrich: None. M. Madani: None. L. Daniels: None. A. Raisinghani: None. A. DeMaria: None. D. Blanchard: None.
- © 2015 by American Heart Association, Inc.