Evaluation of two-dimensional strain echocardiography for quantifying right ventricular function in patients with pulmonary arterial hypertension

Liu, Yong; Wang, Yong; Wang, Yingying; Wang, Zhe

doi:10.3892/etm.2017.4581

Cited by 3 publications

(1 citation statement)

References 25 publications

(22 reference statements)

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“…Addetia K, et al [ 13 ] used RV systolic parameters, such as basal and mid-RV dimensions, length, TAPSE, tissue Doppler S′ velocity, and RV longitudinal strain in normal subjects, and found that RV strain was believed to better represent RV systolic function than longitudinal measurements. Previous studies mainly focused on some diseases may damage RV functions directly, such as pulmonary arteries hypertension [ 14 , 15 ], atrial septal defect [ 16 ], tetralogy of Fallot [ 17 , 18 ], severe tricuspid regurgitation [ 19 ], and so on. Although there were some studies on RV function, the information on RV systolic and diastole functions in T2DM patients using RV layer specific GLS and GLSr was still limited.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of right ventricular systolic and diastolic dysfunctions in patients with type 2 diabetes mellitus with poor glycemic control by layer specific global longitudinal strain and strain rate

Huang

Fan

et al. 2022

Diabetol Metab Syndr

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Background In order to evaluate right ventricular (RV) systolic and diastolic dysfunctions in patients with type 2 diabetes mellitus (T2DM) with poor glycemic control by layer specific global longitudinal strain (GLS) and strain rate (GLSr). Methods 68 T2DM patients and 66 normal controls were enrolled for the present study. RV layer specific GLS (GLSEpi, GLSMid and GLSEndo represent the epimyocardial, middle layer and endomyocardial strains, respectively) and GLSr (GLSr-S, GLSr-E and GLSr-A represent the systole, early-diastole and late-diastole strain rate) were calculated by averaging each of the three regional peak systolic strains and strain rates along the entire RV free-wall (RVFW), entire RV free-wall and septal wall (RVFSW) on RV-focused view. Results The absolute values of RV layer specific GLS (GLSEpi, GLSMid and GLSEndo) in RVFW in T2DM patients were significantly lower than normal controls (P < 0.01), while GLSr-A was significantly larger than normal controls (P < 0.001). The absolute values of RV layer specific GLS (GLSEpi and GLSMid) in RVFSW in T2DM patients were significantly lower than normal controls (P < 0.05), while GLSr-A was significantly larger than normal controls (P < 0.001). HbA1c were poor negatived correlated with GLSEpi in RVFW and RVFSW in T2DM patients (P < 0.05). ROC analysis showed that RV layer specific GLS and GLSr-A had a high diagnostic efficacy in T2DM patients, and GLSr-A in RVFSW have the best diagnostic value in RV diastolic function in T2DM patients (AUC: 0.773). Conclusion From the research, we found that layer specific GLS and GLSr could detect the RV myocardial dysfunctions and confirmed that the impaired RV systolic and diastole functions in T2DM patients with poor glycemic control. GLSr-A in RVFSW had the best diagnostic value in evaluating RV diastolic function in T2DM patients.

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Section: Discussionmentioning

confidence: 99%

Evaluation of right ventricular systolic and diastolic dysfunctions in patients with type 2 diabetes mellitus with poor glycemic control by layer specific global longitudinal strain and strain rate

Huang

Fan

et al. 2022

Diabetol Metab Syndr

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Evaluation of the right ventricle by echocardiography: particularities and major challenges

Dandel

Hetzer

2018

Expert Review of Cardiovascular Therapy

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Compared with the left ventricle (LV), the right ventricle (RV) is less suited for evaluation by echocardiography (ECHO). Nevertheless, RV ECHO-assessment has currently emerged as an important diagnostic tool with meaningful prognostic value and essential contribution to therapeutic decisions. Although significant progress has been made, including generation of higher-quality normative data, validation of several two-dimensional measurements and improvements in three-dimensional ECHO-techniques, many challenges in RV ECHO-assessment still persist. Areas covered: This review discusses the particular challenges and limits in obtaining accurate measurements of RV anatomical and functional parameters and focuses primarily on the difficulties in proper interpretation of the highly load dependent RV ECHO-parameters which complicates the use of this valuable diagnostic and surveillance technique. Expert commentary: There is increasing evidence that RV assessment in relation with its actual loading conditions by ECHO-derived composite variables, which either incorporate a certain functional parameter and load, or incorporate measures which reflect the relationship between RV dilation and RV load, considering also the right atrial pressure (i.e. 'load adaptation index'), is particularly suited for clinical decision-making. Load dependency of RV ECHO-parameters must be taken into consideration especially in patients with advanced RV dysfunction scheduled for LV assist device implantation or lung transplantation.

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Three-Dimensional, Right Ventricular Surface Strain Computation From Three-Dimensional Echocardiographic Images From Patients With Pediatric Pulmonary Hypertension

Kundu¹,

Schäfer

et al. 2023

Journal of Biomechanical Engineering

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Background: Right Ventricular (RV) dysfunction is routinely assessed with echocardiographic-derived global longitudinal strain (GLS). GLS is measured from a two-dimensional echo (2DE) image and is increasingly accepted as a means for assessing RV function. However, any 2D analysis cannot visualize the asymmetrical deformation of the RV nor visualize strain over the entire RV surface. We believe 3D surface (3DS) strain, obtained from 3D echo (3DE) will better evaluate myocardial mechanics. Methods: Components of 3DS strain (longitudinal, LS; circumferential, CS; longitudinal-circumferential shear, ɣCL; principal strains PSMax and PSMin; max shear, ɣMax; and principal angle θMax) were computed from RV surface meshes obtained with 3DE from 50 children with associated PAH, 43 children with idiopathic PAH, and 50 healthy children by computing strains from a discretized displacement field. Results: All 3DS freewall (FW) normal strain (LS, CS, PSMax, and PSMin) showed significant decline at end-systole in PH groups (p<0.0001 for all), as did FW-ɣMax (p=0.0012). FW-ɣMax also changed in disease (p<0.0001). Limits of agreement analysis suggests that 3DS LS, PSMax, and PSMin are related to GLS. 3DS strains showed significant heterogeneity over the 3D surface of the RV. Conclusions: Components of 3DS strain agree with existing clinical strain measures, well classify normal -vs- PAH subjects, and suggest that strains change direction on the myocardial surface due to disease. This last finding is similar to that of myocardial fiber realignment in disease, but further work is needed to establish true associations.

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Evaluation of two-dimensional strain echocardiography for quantifying right ventricular function in patients with pulmonary arterial hypertension

Cited by 3 publications

References 25 publications

Evaluation of right ventricular systolic and diastolic dysfunctions in patients with type 2 diabetes mellitus with poor glycemic control by layer specific global longitudinal strain and strain rate

Evaluation of right ventricular systolic and diastolic dysfunctions in patients with type 2 diabetes mellitus with poor glycemic control by layer specific global longitudinal strain and strain rate

Evaluation of the right ventricle by echocardiography: particularities and major challenges

Three-Dimensional, Right Ventricular Surface Strain Computation From Three-Dimensional Echocardiographic Images From Patients With Pediatric Pulmonary Hypertension

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