Sex- and Method-Specific Reference Values for Right Ventricular Strain by 2-Dimensional Speckle-Tracking Echocardiography

Muraru, Denisa; Onciul, Sebastian; Peluso, Diletta; Soriani, Nicola; Cucchini, Umberto; Aruta, Patrizia; Romeo, G; Cavalli, Giacomo; Iliceto, Sabino; Badano, Luigi P.

doi:10.1161/circimaging.115.003866

Cited by 188 publications

(162 citation statements)

References 31 publications

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“…5 In our single-center validation cohort, LA 3DE volume measurements were tightly correlated and slightly underestimated in comparison with CMR, in line with other validation studies comparing 3DE volumes of LV and RV with CMR. 23,24 The bias was significantly larger in patients with enlarged atria (Figure 4). Our limits of agreement with CMR are similar those reported by Mor-Avi et al, 5 whereas the systematic bias is larger (−8 versus −1 mL).…”

Section: Reference Values For La Volumesmentioning

confidence: 92%

Left Atrial Volumes and Function by Three-Dimensional Echocardiography

Badano

Miglioranza

Mihaila

et al. 2016

Circ: Cardiovascular Imaging

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154

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Because 3-dimensional echocardiography (3DE) does not imply any geometric assumption, it provides a more accurate 5,6 and reproducible 7 measurement of LA volumes than 2DE. Moreover, 3DE LA volume offers an incremental capability to predict cardiovascular events compared with 2DE. 8,9 Thus, 3DE has the potential to become the primary technique to assess LA size and function in clinical practice, pending the availability of robust reference values. At present, reference data of 3DE LA volumes and phasic function are limited. 2,10Accordingly, we designed this study to (1) ; 53 versus 48%, respectively; P<0.001). 3DE LA volumes indexed by body surface area were similar in men and women and increased with age. On multivariable analysis, age, weight, and left ventricular systolic and diastolic function indices resulted as correlates of LA 3DE indices. LA volumes were tightly correlated with cardiac magnetic resonance measurements, yet more underestimated by 2DE versus 3DE (bias±SD: −17±16 versus −7±15 mL, respectively). Among all LA parameters, maximal LA volume and total emptying fraction were the most reproducible, including at test-retest and at expert versus trainee comparisons. Conclusions-This study provides reference values for LA 3DE volumes and function from a relatively large cohort of healthy subjects with a wide age range. Our data may help clinicians to identify LA remodeling and dysfunction.(Circ Cardiovasc Imaging. 2016;9:e004229.

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Section: Reference Values For La Volumesmentioning

confidence: 92%

Left Atrial Volumes and Function by Three-Dimensional Echocardiography

Badano

Miglioranza

Mihaila

et al. 2016

Circ: Cardiovascular Imaging

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154

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“…The largest study providing sex-and methodspecific reference values for RVLS was conducted in 276 healthy volunteers by Muraru et al [53]. Reference values (lower limits of normality) were as follows: (i) six-segment RVLS, -24.7 ± 2.6% (-20.0%) for men and -26.7 ± 3.1% (-20.3%) for women; (ii) free wall (three-segment) RVLS, -29.3 ± 3.4% (-22.5%) for men and -31.6 ± 4.0% (-23.3%) for women.…”

Section: Right Ventricular Strain and Strain Rate By 2d Speckle Trackingmentioning

confidence: 99%

“…Muraru et al [53] also demonstrated that free wall RVLS from a six-segment region of interest was more feasible and reproducible than from a three-segment one.…”

Section: Right Ventricular Strain and Strain Rate By 2d Speckle Trackingmentioning

confidence: 99%

Echocardiographic evaluation of right ventricular systolic function: The traditional and innovative approach

Smolarek¹,

Gruchała

Sobiczewski

2017

Cardiol J.

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Estimation of right ventricular (RV) performance still remains technically challenging due to its anatomical and functional distinctiveness. The current guidelines for the echocardiographic quantification of RV function recommend using multiple indices to describe the RV in a thorough and comprehensive manner, such as RV index of myocardial performance, tricuspid annular plane systolic excursion, fractional area change, Doppler tissue imaging-derived tricuspid lateral annular systolic velocity (S'-wave), three-dimensional RV ejection fraction (3D RVEF), RV longitudinal strain (RVLS)/strain rate by speckle-tracking echocardiography (STE). Among these, the last one mentioned here is an innovative and a particularly promising tool that yields more precise information about complex regional and global RV mechanics. STE was initially designed to evaluate left ventricular function, but recently it has been intro-duced to assess RV performance, which is difficult due to its unique structure and physiology. Many studies have shown that both free wall and 6-segment RVLS present a stronger correlation with the RVEF assessed by cardiac magnetic resonance than conventional parameters and seem to be more sensitive in detecting myocardial dysfunction at an earlier, subclinical stage. (Cardiol J 2017; 24, 5: 563-572)

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“…In healthy subjects, left ventricular longitudinal strain and right atrial longitudinal strain were identified as correlates of RV longitudinal strain, suggesting the capability of 2DSTE to evaluate the functional coupling of the RV with the left ventricle or right atrium. 5 It would be extremely interesting to verify if the same relationships occur also in systemic conditions such as SSc, known to potentially affect both RV and left ventricular myocardium.…”

Section: See Article By Mukherjee Et Almentioning

confidence: 99%

“…The RVFWLS values reported by Mukherjee et al 3 in their control subjects are significantly lower than those reported in the literature. 5,9 However, they used a novel vendor-independent software package (EchoInsight, Epsilon Imaging, Ann Arbor, MI) to measure RVFWLS, whereas the large majority of investigators who applied RVFWLS for RV analysis used a different software (EchoPac, GE Vingmed, Horten, Norway). 2,5,9 In addition, technical details such as the acquisition of the RV view (standard apical 4-chamber versus RV-focused apical 4-chamber view) and the way RV longitudinal strain is defined and calculated (ie, including or not including the interventricular septum) may significantly affect its values.…”

Section: See Article By Mukherjee Et Almentioning

confidence: 99%

Subclinical Right Ventricular Dysfunction by Strain Analysis

Badano

Muraru

2016

Circ: Cardiovascular Imaging

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T he peculiar shape of the right ventricle (RV), its position within the chest, and the thinness of its free wall have always represented a formidable challenge for the assessment of RV size and function by conventional 2-dimensional echocardiography. Over time, a large number of 2D echocardiography and Doppler parameters have been proposed to describe RV geometry and function.1,2 However, most of them are limited by geometric assumptions about RV shape, load dependency, or suboptimal reproducibility, resulting in a limited contribution of conventional echocardiography to the understanding of the role played by the RV in many clinical conditions. See Article by Mukherjee et alIn the last decade, the advent of 2D speckle-tracking echocardiography (2DSTE) has fueled the application of strain imaging to measure the RV myocardial deformation, particularly for an early detection of subclinical myocardial dysfunction, when global ventricular function indices are still normal. The possibility to derive strain parameters from conventional gray-scale images with excellent reproducibility and the relative ease of use of the technique have encouraged researchers to apply 2DSTE for elucidating the extent of RV involvement in a wide variety of cardiac and noncardiac conditions. A PubMed search found >800 articles published on RV strain imaging by echocardiography since 2008.In this issue of Circulation: Cardiovascular Imaging, Mukherjee et al 3 from the Johns Hopkins University School of Medicine report on the ability of 2DSTE longitudinal strain to detect occult abnormalities in regional and global myocardial function of RV free wall in patients with systemic sclerosis (SSc). Conventional 2DE parameters of RV function (eg, tricuspid annular plane systolic excursion and fractional area change) were similar in patients with SSc versus age-and sexmatched controls, whereas RV free wall longitudinal strain (RVFWLS) was found to be significantly impaired in patients with SSc, regardless of pulmonary systolic pressure and SSc phenotype. Moreover, the investigators identified a peculiar regional strain pattern in SSc group, with decreased strain magnitude in the apical and mid segments and increased strain magnitude in the basal segments of the RV free wall. Thus, RVFWLS seems promising in allowing clinicians to identify subclinical RV myocardial impairment in patients with SSc. If these results are confirmed by future studies, evidence of occult RV dysfunction by RVFWLS assessment may prompt for a more intense cardiological follow-up or early treatment of patients with SSc, to avoid or delay the development of overt RV failure.However, the anatomic substrate and the pathophysiology of impaired RVFWLS with altered regional pattern in patients with SSc remain to be clarified. One may hypothesize 2 major contributions to RV impaired performance in patients with SSc: higher pulmonary load because of vessel stiffness/sclerosis or primary intrinsic myocardial dysfunction. Mukherjee et al 3 deserve credit for evaluating RVFWLS together w...

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Sex- and Method-Specific Reference Values for Right Ventricular Strain by 2-Dimensional Speckle-Tracking Echocardiography

Cited by 188 publications

References 31 publications

Left Atrial Volumes and Function by Three-Dimensional Echocardiography

Left Atrial Volumes and Function by Three-Dimensional Echocardiography

Echocardiographic evaluation of right ventricular systolic function: The traditional and innovative approach

Subclinical Right Ventricular Dysfunction by Strain Analysis

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