Speckle Tracking Imaging in Patients with Pulmonary Hypertension

Abstract

BACKGROUND Right ventricular (RV) systolic dysfunction is a strong predictor of mortality in pulmonary hypertension (PH). The goal of this study was to investigate whether right atrium (RA) and RV myocardial strain related to PH using speckle tracking echocardiography provide a superior estimation of RV systolic function than 2-dimensional (2D)-echo. METHODS This cross-sectional study analyzed 22 patients with a diagnosis of PH stratified by right heart catheterization, and they were compared to a control group of 22 age- and sex-matched healthy subjects. RESULTS Global longitudinal peak systolic strain measured in the RV free wall from the apical 4 chamber view was −15% vs. −14.5% when measured from the subcostal view (p = 0.99). Mean longitudinal strain during reservoir phase, and longitudinal strain rate during atrial reservoir and passive conduit function was significantly impaired measured in the right atrial free wall in patients with PH. CONCLUSIONS This study showed impaired LV contractility in patients with PH assessed by speckle tracking strain. RV free wall longitudinal strain does not correlate with any of the measurements of RV systolic function obtained by 2D echocardiography. A major strength of RV longitudinal strain is its ability to assess the RV function without the limitations of 2D parameters. The subcostal RV strain is a feasible and accurate alternative to conventional RV strain from the apical view in patients with poor acoustic apical 4-chamber windows. The RA strain and strain rates values may be a valuable additive to assess right-sided heart function.

Changes in the indicators of hemodynamics and oxygen transport in patients with idiopathic pulmonary arterial hypertension depending on their survival

“…Далі автоматичний алгоритм програмного забезпечення апарата із одного вихідного кадру відслідковував ендокардіальну межу протягом повного серцевого циклу. Крім цього, додатково було вручну виконане точне налаштування меж, щоб гарантувати відслідковування всіх сегментів належним чином [6]. Показники СТ-ЕхоКГ, які ми визначали: глобальна поздовжня деформація ЛШ (ГПД ЛШ), поздовжня деформація вільної стінки ПШ (ПДВС ПШ) [7].…”

How to Determine Right Ventricular Dysfunction in Pulmonary Hypertension

“…In the current issue of Journal of Cardiovascular Imaging , Prieto et al 16) compared global RV longitudinal strain, RA strain, and strain rate between normal controls and patients with PH. They demonstrated that RV free wall longitudinal strain (RVFWSL), global right atrial reservoir strain, peak strain rate during reservoir phase, and peak strain rate during passive conduit phase in the RA free wall were significantly reduced in patients with PH compared to normal controls.…”