Right ventricular outflow tract systolic excursion and fractional shortening: Can these echocardiographic parameters be used for the assessment of right ventricular function?

Abstract

Background:Echocardiographic right ventricular (RV) function assessment is difficult and still a gray area despite rapid advancement of imaging modalities. The aim of this study is to assess the role of echocardiographic RV outflow tract (RVOT) function in the form of RVOT fractional shortening (RVOT FS) and RVOT systolic excursion (RVOT SE) for the assessment of RV function.Methods:We studied ninety individuals divided equally into two groups. The control group included 45 normal healthy individuals and age-matched patient group included 45 patients with RV dysfunction which was defined by tricuspid annular plane systolic excursion (TAPSE) <16 mm and RV fractional area change (RV FAC) ≤35%. Echocardiography was performed to measure RVOT FS and RVOT SE and correlate them with other parameters of RV function including TAPSE, RV FAC, peak systolic velocity of the lateral tricuspid annulus (S’) using pulsed tissue Doppler, and pulmonary acceleration time (PAcT).Results:RVOT FS showed positive correlation with TAPSE (r = 0.75, P = 0.02), RV FAC (r = 0.45, P = 0.003), and PAcT (r = 0.39, P = 0.00) and negative correlation with left atrial dimensions (LADs) (r = −0.359, P = 0.017) and left ventricular end-diastolic dimensions (r = −0.304, P = 0.042). RVOT FS <32% was 93% sensitive and 98% specific to identify patients with impaired RV function. However, RVOT SE showed weak correlation with echocardiographic RV parameters. RVOT SE <5 mm was 80% sensitive and 76% specific to identify patients with impaired RV function.Conclusion:RVOT FS is a simple valuable parameter that can be used for the assessment of RV function. However, RVOT SE is less accurate than RVOT FS in RV function assessment.

Echocardiographic Findings in Canine Model of Chagas Disease Immunized with DNA Trypanosoma cruzi Genes

“…There are some studies that report systematic tests for right ventricular dysfunction by FS evaluation. Right ventricular function is an important predictor of mortality and quality of life in patients with LV failure, myocardial infarction, congenital heart disease, and pulmonary hypertension [43,44]; according to this, we suggest that non-vaccinated dogs developed an ability reduction of the myocardial fibers to distend, which together with the diastolic dimensions suggests little contractility. It is documented that a high afterload hindering muscle contraction could show a decreased FS as an important feature by echocardiography [43], such as that we can observe in those non-vaccinated/infected dogs, suggesting an impairing in general cardiac function.…”

Early right ventricular dysfunction in highly selected (totally free from cardiovascular risk factors and other comorbidities) human immunodeficiency virus patients: A pilot study with advanced echocardiography

“…Furthermore, as echocardiographic RV function assessment still represents a challenge despite rapid improvement in imaging facilities, other reliable parameters might have been used. [16] For example, an undoubtedly useful measurement, such as RV 3D EF, was not calculated because the commercial software that we used had not been previously validated to do that. We chose to seek possible correlations with FAC, as according to guidelines, it is a measure of RV systolic function that was shown to correlate with RV EF by MRI.…”

Clinically inapparent right heart dysfunction is associated with reduced myofilament force development in coronary artery disease

“…Identifying patients at risk for impaired right heart function could be helpful in risk-stratification of surgical candidates with symptomatic coronary artery disease (CAD) [ 3 ]. Due to the complex geometry of the right heart, its functional assessment is cumbersome [ 4 , 5 ]. The ACC/AHA and ESC guidelines recommend TAPSE, for estimating RV global systolic function [ 5 , 6 ].…”