Background: the prevalence of right bundle branch block (RBBB) is estimated to be 0.2-2.3% in healthy individuals in many previous studies. The prevalence of RBBB increases with age, higher in men, diabetics and in patients with hypertension. Objectives: the purpose of this study was to evaluate the right ventricular systolic function in patients with right bundle branch block with structurally normal heart disease using conventional and speckle tracking 2D echocardiography. Subjects and Methods: forty patients with right bundle branch block (RBBB) were classified into 2 groups each of 20 patients; complete right bundle branch block (CRBBB) and incomplete RBBB (IRBBB), beside 20 normal individuals matched in age and sex served as controls. Results: Tricuspid annular plane systolic excursion (TAPSE) and right ventricle free wall longitudinal strain (RV FWLS) were not statistically significant in patients with RBBB, there was decrease in CRBBB than normal individuals. In right ventricle global longitudinal strain (RV GLS), tricuspid lateral annular systolic velocity (S'), Tei index by both tissue and pulsed Doppler assessment, fractional area change (RV FAC%) and RV basal diameter; and in incomplete right bundle branch block in the mean of RV STE GLS%, S', Tei index by both tissue and pulsed Doppler. Conclusion: Isolated right bundle branch block has an effect on the RV morphologic characteristics, systolic function compared with healthy individuals by 2D, M-mode, Doppler and speckle tracking echocardiographic assessment.
Background: Ischemic cardiomyopathy [ICM] refers to the reduced pumping ability of the heart due to damage of myocardium as a result of ischemia. Thus, early detection of coronary artery disease could save the myocardium. Speckle tracking emerged as a new diagnostic tool, but its role in ischemic cardiomyopathy is not well addressed. Aim of the work: To assess right ventricle [RV] function by two-dimensional [2D] speckle tracking imaging in patients with ICM. Patients and Methods: This study included 38 patients with ICM and 30 healthy subjects as a control group. Conventional echo-Doppler parameters of right ventricular function together with tissue Doppler imaging derived RV strain and speckle-tracking echo-derived RV global strain [STE-RVGST] were addressed. Results: The two groups were matched in age and sex. ICM had significantly higher values of LV Tei index [0.90±0.28] versus control group [0.51±0.13] with p value <0.001. Compared to control group, ischemic cardiomyopathy patients had significantly dilated right ventricular [RV] dimensions and volumes with impaired systolic and diastolic function. In this study RV tissue Doppler imaging [TDI] revealed statistically significant low Free Ea [6.76±2.72 versus 8.20±1.86], Free Sa [8.00±2.86 versus 10.91±1.10], TD-derived RV strain [19.83±15.19 versus 33.87±5.82] in ICM than control group. Speckle tracking derived global longitudinal strain was statistically lower in ICM [-10.01±3.7] versus-18.83±3.34 in control group. Conclusion: Patients with ischemic cardiomyopathy have both systolic and diastolic RV dysfunction, Speckle tracking echocardiography have an additive role in assessment of RV systolic dysfunction.
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