Evaluation of Right Ventricular Contraction by Myocardial Strain in Children Using a Two-Dimensional Tissue Tracking Method

Abstract

Two-dimensional tissue tracking makes it possible to detect myocardial strain in any direction. Consequently, this method is applicable for evaluation of myocardial dyssynchrony. This study enrolled 22 healthy volunteers (11 boys and 11 girls) ages 1.6 to 10.8 years (mean, 6.8 years). Echocardiography (subxiphoid right anterior oblique view) of the right ventricle was examined. Three tracking points were put on the right ventricle, and time-strain curves of the inflow tract (strain at the inlet) and the outflow tract (strain at the outlet) as well as time-strain curve of the pulmonary annulus diameter were made. The strain at the inlet was larger than the strain at the outlet (0.31 vs 0.15; p = 0.0003). The time to peak negative strain at the inlet was longer than at the outlet (0.48 vs 0.42 s; p = 0.001). The diameter of the pulmonary annulus shortened in systole, and the time to peak negative strain of the pulmonary annulus was longer than that of the outlet (0.48 vs 0.42; p = 0.001). There was no significant difference in the times between the pulmonary annulus and the inlet (0.48 vs 0.48; p = 0.78). Two-dimensional tissue tracking allows assessment for quantification of myocardial performance and timing of the right ventricle.

Relationship between temporal sequence of right ventricular deformation and right ventricular performance in patients with corrected tetralogy of Fallot

“…However, in the longitudinal direction the peristalsis-like pattern was not observed 21 22. These findings were recently confirmed by Matsui and coworkers 7. The authors assessed longitudinal shortening at the RV free wall and at the RV outflow tract with two-dimensional tissue tracking in healthy volunteers.…”

“…From an anatomical and embryological perspective, the RV can be divided into two sections: the sinus (inlet) and the infundibulum (outlet) 5 6. Previous studies have demonstrated the presence of temporal differences in motion between the RV inlet and outlet in patients with cToF as well as in healthy subjects 4 7. However, characterisation of the RV mechanical activation sequence with different imaging techniques provided conflicting data 4 7 8.…”

“…Previous studies have demonstrated the presence of temporal differences in motion between the RV inlet and outlet in patients with cToF as well as in healthy subjects 4 7. However, characterisation of the RV mechanical activation sequence with different imaging techniques provided conflicting data 4 7 8. In addition, the relationship between the RV temporal mechanical activation pattern and RV performance has not been elucidated.…”

Evaluation of myocardial function in pediatric patients with transposition of great arteries after arterial switch operation

“…However, TDI allows regional myocardial velocities and systolic and diastolic intervals to be measured (29, 30). Therefore, TDI is superior and more sensitive than conventional echocardiography for detecting subclinical abnormalities in RV (28).…”

Echocardiographic evaluation of right heart function and pulmonary vascular bed

“…In addition, RV function cannot easily appraisable because RV is a triangle-shaped chamber composed of the inlet portion, the outlet portion, and the apical portion with rough trabeculations having a complex architecture. For these reasons, RV global and regional function can be more entirely evaluated with speckle-tracking method [42].…”