Abstract 20625: The Significance of Right Ventricular Regional Strain in Determining the Global Right Ventricular Function
Background: We performed clinical studies to assess the significance of right ventricular (RV) regional strain of a novel 3D-speckle tracking imaging (STE) system in determining the RV ejection fraction (EF) by cardiac magnetic resonance (CMR).
Methods and results: To validate RV segmental strain significance, 75 patients (71%) among 106 patients with adequate quality 3D echocardiographic data were enrolled. The background heart diseases were 38 cardiomyopathy and 37 adult congenital heart diseases. 3D-STE–derived area change ratio (ACR), longitudinal strain (LS), and circumferential strain (CS) were assessed as global, inlet, outflow, and apical segments datasets using dedicated software (Toshiba Medical systems). RV measurements derived from 3D-STE and CMR were closely related (RV end-diastolic volume (RVEDV), R2=0.84; RV end-systole volume, R2=0.83; RV ejection fraction (RVEF), R2=0.70, all p<0.001), while, RVEDV, and RVEF, as determined using 3D-STE, were significantly smaller than values determined using CMR (mean difference was -2% in RVEF and -10ml in RVEDV). Among the segmental 3D-strain variables, all variables except for apical circumferential strain showed significant relations with RVEF. Stepwise method revealed that inlet AS and outflow CS were selected to be the independent significant determinants of RVEF. Among conventional echocardiographic parameters for RV function, which were tricuspid annulus plain systolic excursion, fractional area change (FAC), S’ of tricuspid annulus, RV free wall 2D longitudinal strain, only FAC showed significant relation with RVEF (R=0.34, p=0.003) in our population.
Conclusions: Three dimensional speckle tracking derived global area strain, especially inlet area strain and outflow circumferential strain, may be the important determinant for RVEF among patients with the various underlying heart disease including adult congenital heart disease.
Author Disclosures: T. Ishizu: None. Y. Seo: None. Y. Tanaka-Onishi: None. H. Horigome: None. Y. Kawakami: None. K. Aonuma: None.
- © 2016 by American Heart Association, Inc.