4093Beyond global longitudinal strain: early impairment of apical function after antracyclines therapy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Manganaro ◽  
L Longobardo ◽  
M Cusma' Piccione ◽  
A Bava ◽  
R Costantino ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Troponin I ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Interventricular Septum ◽  
P Value ◽  
Apical Segment ◽  
Regional Strain

Abstract Purpose To confirm GLS diagnostic sensitivity as parameter for the evaluation of LV systolic function in women with breast cancer who underwent chemotherapy including anthracyclines and to identify a pattern of decreased 2D speckle tracking regional longitudinal strain through the analysis of polar maps obtained with AFI technology. Methods We enrolled 60 female patients (age with 56.5±12 years) with breast cancer before the beginning of chemotherapy. The study protocol included clinical examination, ECG with QTc calculation, lab test (BNP and troponin I) and echocardiography with TDI and speckle tracking analysis (STI), that were performed before the beginning of the chemotherapy (basal) and after 3, 6 and 12 months. Echocardiography evaluation included the following parameters: LV end-diastolic and end-systolic volumes, LV ejection fraction (EF), average TDI S' at the mitral annulus, Global Longitudinal Strain (GLS), regional longitudinal strain, E/A ratio, E/E' ratio and sPAP. For each patient we analyzed the bull's eye maps before the beginning of the therapy (basal value) and when GLS showed the lowest values during the FU (FU value), to identify the pattern of regional longitudinal strain alterations. We compared basal and FU strain values for each of the 17 LV segments and the difference between them (delta) was calculated according to the formula [(FU LS –basal LS, (%)]. Results During the FU, systolic blood pressure, systolic pulse pressure and BNP values increased from the basal assessment to the 3 and 6 months FU. Similarly, a progressive worsening of GLS values has been observed (basal −20.4±2.6%, 3 months FU −18.2±2.5%, 6 months FU −17.7±2.9, 12 months FU −17.6±3, p value <0.001). Through the analysis of polar maps, we observed that regional strain values worsened significantly in all the LV segments but the most evident impairment was reported in the apical cap (−22.8±3.9 vs −17.1±3.8; p<0.001, Δ=−5,78%) and in the apical segment of the anterior interventricular septum (−23.4±4.5 vs −17±6.3; p<0.001, Δ=−6,2%), as reported in Figure. Conclusion GLS is able to identify LV systolic dysfunction that EF is not able to detect. However, since that it describes the global function of LV, GLS could result as normal (18–20%) when strain impairment of some LV segments is counterbalanced by the compensatory strain increase of other segments, determining an misdiagnosis of myocardial damage. Regional strain and particularly the Δ-strain, seem to suggest that anthracyclines induce a damage more evident in the apical cap and in the apical segment of the interventricular septum and this pattern could be typical in these patients. Thus, polar maps analysis could be provide additional information about cardiac damage in this population.

scholarly journals Assessment of myocardial deformation with CMR: a comparison with ultrasound speckle tracking in a cohort of highly trained endurance athletes

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
B Domenech-Ximenos ◽  
M Sanz-De La Garza ◽  
A Sepulveda-Martinez ◽  
D Lorenzatti ◽  
F Simard ◽  
...  
Keyword(s):  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Myocardial Deformation ◽  
Endurance Athletes ◽  
National Budget ◽  
Complex Anatomy ◽  
Exercise Induced ◽  
Public Grant

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Plan Nacional I.D., Del Programa Estatal de Fomento De La Investigación Científica y Técnica de Excelencia, Subprograma De Generación Del Conocimiento, Ministerio de Economía y Competitividad 2013. Background  Myocardial deformation integrated with cardiac dimensions provides a comprehensive assessment of the ventricular remodelling patterns induced by cumulative effects of intensive exercise. Feature tracking(FT) can measure myocardial deformation from cardiac magnetic resonance(CMR) cine sequences; however, its accuracy is still scarcely validated. Purpose  Our aim was to compare FT’s accuracy and reproducibility to speckle tracking echocardiography (STE) in highly trained endurance athletes (EAs). Methods  93 EAs (&gt;12 hours training/week during the last 5 years, 52% male, 35 ± 5.1 years) and 72 age-matched controls underwent a resting CMR and a transthoracic echocardiography to assess biventricular exercise-induced remodelling and biventricular global longitudinal strain (GLS) by CMR-FT and STE. Results   High endurance training load was associated with larger bi-ventricular and bi-atrial sizes and mildly reduced systolic function of both ventricles (p &lt; 0,05). Strain values (both by CMR-FT and STE) proportionally decreased with increasing ventricular volumes potentially depicting the increased volume and functional biventricular reserve that characterize EAs heart. Strain values were lower when assessed by CMR-FT as compared to STE (p &lt; 0.001), with good reproducibility for the LV (bias = 3.94%, LOA= ± 4.27%) but wider variability for RV strains (Figure 2). Conclusions   Biventricular longitudinal strain values were lower when assessed by FT compared to STE. Both methods were comparable when measuring LV strain but not RV strain. These differences might be justified by FT’s lower in-plane spatial and temporal resolution, which is particularly relevant for the complex anatomy of the RV. Abstract Figure. Fig 1. Bland-Altman plots; FT vs STE.

scholarly journals Left ventricular systolic function impairment in children after balloon valvuloplasty for congenital aortic stenosis assessed by 2D speckle tracking echocardiography

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0248862
Author(s):  
Krzysztof Godlewski ◽  
Paweł Dryżek ◽  
Elżbieta Sadurska ◽  
Bożena Werner
Keyword(s):  
Strain Rate ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Circumferential Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Strain And Strain Rate ◽  
Eccentric Hypertrophy

Aims The aim of the study was to evaluate left ventricular (LV) remodeling and systolic function using two-dimensional speckle tracking echocardiographic (2D STE) imaging in children at a long-term (more than 36 months, 107.5±57.8 months) after balloon valvuloplasty for aortic stenosis (BAV). Methods and results 40 patients (mean age 9,68 years, 75% male) after BAV and 62 control subjects matched to the age and heart rate were prospectively evaluated. The 2D STE assessment of LV longitudinal and circumferential strain and strain rate was performed. Left ventricular eccentric hypertrophy (LVEH) was diagnosed in 75% of patients in the study group. Left ventricular ejection fraction (LVEF) was normal in all patients. In study group, global longitudinal strain (GLS), global longitudinal strain rate (GLSr) were significantly lower compared with the controls: GLS (-19.7±2.22% vs. -22.3±1.5%, P< 0.001), GLSr (-0.89±0.15/s vs. -1.04 ±0.12/s, P < 0.001). Regional (basal, middle and apical segments) strain and strain rate were also lower compared with control group. Global circumferential strain (GCS), global circumferential strain rate (GCSr) as well as regional (basal, middle and apical segments) strain and strain rate were normal. Multivariable logistic regression analysis included: instantaneous peak systolic Doppler gradient across aortic valve (PGmax), grade of aortic regurgitation (AR), left ventricular mass index (LVMI), left ventricular relative wall thickness (LVRWT), left ventricular end-diastolic diameter (LVEDd), peak systolic mitral annular velocity of the septal and lateral corner (S’spt, S’lat), LVEF before BAV and time after BAV and showed that the only predictor of reduced GLS was LV eccentric hypertrophy [odds ratio 6.9; (95% CI: 1.37–12.5), P = 0.045]. Conclusion Patients at long-term observation after BAV present the subclinical LV systolic impairment, which is associated with the presence of its remodeling. Longitudinal deformation is the most sensitive marker of LV systolic impairment in this group of patients.

P5002The impact of diabetes mellitus on global longitudinal strain of patients with acute heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Kwak ◽  
I.-C Hwang ◽  
J.-J Park ◽  
J.-H Park ◽  
G.-Y Cho ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Propensity Score ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
P Value ◽  
Matched Cohort ◽  
Entire Cohort ◽  
The Impact

Abstract Introduction Diabetes mellitus (DM) aggravates the clinical features and the prognosis of heart failure (HF) patients. However, the impact of DM on the ventricular systolic function of HF patients is not well delineated. Purpose The present study aimed to investigate the impact of DM on HF, regarding the systolic function presented by the global longitudinal strain (GLS). Methods In 4312 patients with acute HF, left ventricle (LV) and right ventricle (RV) GLS were acquired by speckle-tracking echocardiography. HF patients with DM were compared to those without DM from the entire cohort (n=4312), as well as the propensity-score matched cohort (n=3034). Results Our cohort consisted of 1750 DM patients (40.6%). Both LV-GLS and LVEF were significantly lower within the patients with DM (10.1±4.8% vs. 11.3±5.1%, p<0.001 for LV-GLS; 39.1±15.5% vs. 41.7±15.6%, p<0.001 for LVEF) in the entire cohort. In the propensity-score matched cohort, LV-GLS was significantly reduced in the patients with DM compared to those without DM (10.2±4.9% vs. 10.9±5.0%, p<0.001), even with the matched LVEF (Table 1). Decreased LV-GLS in the DM patients was consistently identified in both subgroups of preserved EF and reduced EF (Table 1). Although RV-GLS was slightly lower in the patients with DM from the matched cohort, it was not significant in neither the preserved EF nor the reduced EF subgroup. When comparing the adverse outcome in the propensity-score matched cohort, the survival of patients with DM was significantly lower (Figure 1-A, 1-B), except for the preserved EF group (Figure 1-C). Comparison between heart failure patients with and without diabetes in the matched cohort Matched cohort p-value HFrEF (matched) p-value HFpEF (matched) p-value No-DM (n=1517) DM (n=1517) No-DM (n=823) DM (n=801) No-DM (n=652) DM (n=669) Age, years 71±14 71±11 0.962 69±14 70±11 0.305 75±11 74±10 0.061 Ischemic heart disease, n (%) 545 (35) 575 (37) 0.275 375 (36) 402 (39) 0.238 150 (34) 147 (34) 0.945 GFR, mL/min/1.73m2 56±27 55±27 0.282 58±28 56±27 0.253 54±27 54±26 1.000 HbA1C, % 5.7±0.4 7.3±1.4 <0.001 5.7±0.4 7.3±1.4 <0.001 5.7±0.4 7.2±1.4 <0.001 LV ejection fraction, % 39±15 39±15 0.871 31±9 31±10 0.99 59±5 59±6 0.279 LV-GLS, % 10.9±5.0 10.2±4.9 <0.001 9.1±3.8 8.3±3.6 <0.001 15.5±4.5 14.9±4.5 0.036 RV-GLS, % 13.1±6.5 12.7±6.2 0.045 12.1±6.2 11.8±5.9 0.188 15.6±6.5 15.0±6.4 0.157 Figure 1. Outcome by DM status Conclusions DM is associated with the impaired LV systolic function presented by GLS in HF patients, even with the adjustment of LVEF. The result indicates that GLS is a more sensitive marker of systolic function than LVEF, in terms of the DM status among the HF patients.

scholarly journals Left ventricular function in rheumatoid arthritis during anti-TNF-α treatment: a speckle tracking prospective echocardiographic study

2016 ◽  
Vol 84 (1-2) ◽  
Author(s):  
Enrico Vizzardi ◽  
Ilaria Cavazzana ◽  
Franco Franceschini ◽  
Ivano Bonadei ◽  
Edoardo Sciatti ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Failure ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Cardiac Complications ◽  
Tnf Α ◽  
One Year

<p><strong>Aim</strong>. Rheumatoid arthritis (RA) shows a high risk for cardiovascular disease, including heart failure. Although TNF-α has been implicated in the pathogenesis of myocardial remodelling, TNF-α inhibition did not show any efficacy in patients with advanced heart failure and should be contraindicated in RA with cardiac complications. We aimed to assess global left ventricular (LV) systolic function using global longitudinal strain (GLS) as a measure of myocardial deformation, in a group of RA patients before and during anti-TNF-α treatment. <strong>Methods</strong>. 13 patients (female:male 7:6) affected by RA were prospectively followed for one year during anti TNF-α treatment. Every subject underwent echocardiography before starting anti-TNF-α drugs and after one year of treatment, to evaluate LV ejection fraction (EF), telediastolic diameter, telediastolic volume and global longitudinal strain (GLS) that was calculated using 2D speckle tracking as the mean GLS from three standard apical views (2, 3 and 4 -chambers). The patients showed a mean age of 43 years at RA onset (SD: 13) and a mean follow-up of 7.3 years (SD: 4.8). Steroid and methotrexate were used in 84.6% and 100%, respectively, in association with etanercept (6 cases), adalimumab (4 cases) and infliximab (3 cases). <strong>Results</strong>. Patients globally showed a normal EF before and after one year of treatment (mean: 65% and 65.7%, respectively). GLS did not differ before or after anti-TNF-α treatment (mean: -15.8% and -16.7%, respectively). <strong>Conclusion</strong>. Anti-TNF-α treatment did not significantly modify myocardial contractility after 12 months.</p><p> </p><p> </p>

scholarly journals Assessment of global longitudinal strain and plasma natriuretic peptide in patients with asymptomatic left ventricular dysfunction

Kardiologiia ◽  
2021 ◽  
Vol 61 (10) ◽  
pp. 53-60
Author(s):  
Ganchimeg Ulziisaikhan ◽  
Mungun-Ulzii Khurelbaatar ◽  
Chingerel Khorloo ◽  
Naranchimeg Sodovsuren ◽  
Altaisaikhan Khasag ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Roc Curve ◽  
Longitudinal Strain ◽  
Troponin I ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Lv Systolic Function

Objective    The purpose of this study was to investigate the association between global longitudinal strain (GLS) and plasma NT-proBNP for predicting left ventricular (LV) performance in asymptomatic patients after acute myocardial infarction (AMI).Material and methods    We prospectively included patients with diagnosis of AMI without clinical signs and symptoms of heart failure (HF) and followed these patients for 6 mos. Baseline echocardiography was performed at admission, and follow-up echocardiography was performed after 6 mos. A normal GLS was defined as having an absolute value of ≥16 %. According to the baseline GLS, participants were divided into two groups and compared. In all participants, blood samples of plasma NT-proBNP were obtained at admission, before discharge, and 6 mo after discharge.Results    The study population was consisted of 98 participants, of which 80 (81.6 %) were males, and the mean age was 56.0±9.3 years. Baseline echocardiography showed that most of the participants (60, 61.2 %) had abnormal GLS<16 %, whereas 38 (38.8 %) participants had normal or borderline GLS ≥16 %. Compared with the normal GLS group, participants with abnormal GLS had higher GRACE score, higher troponin I concentration, lower systolic blood pressure, lower mean LV ejection fraction, and decreased LV diastolic function. At 6‑mo follow-up, only LV systolic function remained significantly different between the two groups. Compared to baseline, there was a significant improvement of GLS in the abnormal GLS group at 6‑mo follow-up (p=0.04). Prevalence of complications after AMI was significantly higher in this group. There were significant differences between baseline and discharge NT-proBNP concentrations between the two groups (p<0.05). In the abnormal GLS group, there were significant correlations between baseline and discharge NT-proBNP concentrations with baseline LV systolic function. Discharge NT-proBNP concentration also correlated significantly with 6‑mo follow-up GLS. For determining the effect of baseline GLS abnormality, the areas under the ROC curve for baseline and discharge NT-proBNP concentrations were 0.73 (95 % CI 0.60–0.85, p=0.001) and 0.77 (95 % CI 0.66–0.87, p<0.001), respectively. Regarding early prediction of follow-up GLS abnormality, the area under the ROC curve for discharge NT-proBNP concentration was significantly higher 0.70 (95 % CI 0.55–0.84, p=0.016). The optimum cut-off value of discharge NT-pro-BNP was 688.5 pg / ml, with 72.4 % sensitivity and 65.4 % specificity to predict 6‑mon GLS abnormality following acute myocardial infarction.Conclusion    The main finding of this study is that impaired LV GLS is associated with elevated plasma concentrations of NT-proBNP in post-AMI patients. Pre-discharge NT-proBNP concentration combined with impaired initial GLS could predict worsening LV systolic function over time in asymptomatic post-AMI patients.

scholarly journals Subclinical LV Dysfunction Detection Using Speckle Tracking Echocardiography in Hypertensive Patients with Preserved LV Ejection Fraction

2016 ◽  
Vol 10 ◽  
pp. CMC.S38407 ◽  
Author(s):  
Amal Mohamed Ayoub ◽  
Viola William Keddeas ◽  
Yasmin Abdelrazek Ali ◽  
Reham Atef El Okl
Keyword(s):  
Ejection Fraction ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Systolic Dysfunction ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Control Group ◽  
Hypertensive Patients

Background Early detection of subclinical left ventricular (LV) systolic dysfunction in hypertensive patients is important for the prevention of progression of hypertensive heart disease. Methods We studied 60 hypertensive patients (age ranged from 21 to 49 years, the duration of hypertension ranged from 1 to 18 years) and 30 healthy controls, all had preserved left ventricular ejection fraction (LVEF), detected by two-dimensional speckle tracking echocardiography (2D-STE). Results There was no significant difference between the two groups regarding ejection fraction (EF) by Simpson's method. Systolic velocity was significantly higher in the control group, and global longitudinal strain was significantly higher in the control group compared with the hypertensive group. In the hypertensive group, 23 of 60 patients had less negative global longitudinal strain than −19.1, defined as reduced systolic function, which is detected by 2D-STE (subclinical systolic dysfunction), when compared with 3 of 30 control subjects. Conclusion 2D-STE detected substantial impairment of LV systolic function in hypertensive patients with preserved LVEF, which identifies higher risk subgroups for earlier medical intervention.

scholarly journals Systolic Aortic Root Motion and Angle as novel indices of Left Ventricular Systolic Function

2020 ◽  
Author(s):  
ghada m soltan ◽  
ahmed m el kersh ◽  
nevien e sami ◽  
ghadeer m yehia ◽  
mahmoud ali soliman
Keyword(s):  
Aortic Root ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
P Value ◽  
Ventricular Systolic Function ◽  
Global Left Ventricular ◽  
Motion Amplitude

Abstract Background Aortic root motion was used only as a surrogate parameter of global left ventricular systolic function depending on its direct proportion to cardiac output. We hypothesize that aortic root motion angle and aortic root motion amplitude may overcome many limitations of EF calculation by M mode and two dimensional methods and are easier and reproducible.Objective The aim of this study is to asses systolic aortic root motion measured by M mode and aortic root motion angle as novel indices of global left ventricular systolic function.Patients and methods one hundred patients were enrolled in this study and divided into four groups: according to their age (above and below 60 years) and EF (above and below50%). They were subjected to full history taking, careful clinical examination, and conventional echo-Doppler study .Systolic aortic root motion obtained from long axis parasternal view by M-mode echo guided by 2D echo, and aortic root motion angle was traced off line and mathematically measured. Also global logitudinal strain (GLS) and global longitudinal strain rate (GLSR) from apical 4,3 and 2 chamber views were measured offline.Results Statistical analysis of collected data show that there are significant differences between control groups and patient groups in aortic root motion angle (t= 16.9 and p value <0.001, and in aortic root motion amplitude (t= 20.1 and p value <0.001). Aortic root motion (cm) and aortic root motion angle have significant positive correlation with EF(Mm), EF(2D), Fs, global longitudinal strain(GLS) and global Strain rate . The best cutoff value of aortic root motion angle was 19.5 degree, with sensitivity of 93.9%, specificity of 96.1.Aortic root motion angle >19.5 predicts systolic function >50% and that<19.5 predicts systolic function <50% The best cutoff value of aortic root SAM was 8.5 mm. An aortic root SAM of ˂ 8.5 mm predicts an LVEF of ˂ 50% with sensitivity of 95.9%, specificity of 96.1%.Conclusion The amplitude of systolic aortic root motion (SARM) by (M-mode) and aortic root motion angle are well- correlated with the EF and GLS and could be considered as novel indices of global left ventricular systolic function with high accuracy and reproducibility .

scholarly journals Can right ventricular speckle tracking imaging be used in arrhytmogenic cardiomyopathy screening? A study of healthy paediatric athletes with and without echocardiographic modified task force criteria

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
D Dorobantu ◽  
N Riding ◽  
G Mcclean ◽  
C Adamuz ◽  
D Ryding ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Task Force ◽  
Systolic Function ◽  
Right Ventricular Outflow Tract ◽  
P Value ◽  
Free Wall ◽  
Medical Systems ◽  
N 93

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): The study was support by a contractual research partnership between the University of Bristol and Canon Medical Systems UK. Background Arrhytmogenic cardiomyopathy (ACM) is a major cause of sudden cardiac death among young athletes. Screening these individuals can be challenging due to right ventricular (RV) exercise-related remodelling, particularly right ventricular outflow tract (RVOT) dilation. Recent studies have also shown that peak RV longitudinal strain (Sl) measured by speckle tracking echocardiography (STE) is reduced in adolescents with definite and borderline ACM. The prevalence of RV changes meeting ACM criteria in healthy paediatric athletes, and whether these changes are associated with abnormal RV strain values is not known. Purpose The aim of this study is to evaluate the prevalence of healthy paediatric athletes meeting the ACM echocardiographic modified Task Force Criteria (mTFC) for RVOT dilation, and how this relates to RV longitudinal systolic function. Methods Athletes under 18 years old undergoing comprehensive pre-participation screening (2014-2017) at two sports academies were included. Global (RV-Sl) and free wall peak systolic strain (FW-Sl) were calculated using STE. Three groups were defined: meeting the major mTFC for RVOT size (M-mTFC), meeting the minor mTFC (m-mTFC) and not meeting the mTFC (no-mTFC). RV-Sl and FW-Sl were compared using the Kruskall Wallis test. Results A total of 247 boys (11.1-18 years, median 14.6 years) were included, with diverse ethnicity (53.1% Arab, 27.6% Black, 17.6% White, and 1.7% other) and sports background (50.6% football, 27.9% athletics, 21.5% other). Of these n = 22 were in the M-mTFC group (8.9%), n = 93 in the m-mTFC group (37.7%) and n = 132 in the no-mTFC group (53.4%). No regional RV wall motion abnormalities were observed. There were no differences in RV-Sl or FW-Sl by mTFC Group (Table 1). Conclusions In healthy paediatric athletes, 9% met the major mTFC, and 38% met the minor mTFC for RVOT size. RV longitudinal strain was found to be similar between those who met the mTFC and those who did not. This highlights the probable non-pathological adaptations reflected by RVOT dilation in these individuals, as opposed to those seen in ACM. The results of this study suggest that STE can be a valuable tool in ACM screening in paediatric athletes, especially in cases where RV remodelling is present. RV peak longitudinal strain by mTFC All M-mTFC n = 22 m-mTFC n = 93 no-mTFC n = 132 p value for between group comparison Global RV Sl (median, IQR) -23.3% (-25.2;-21.7) -23.3% (-25.5;-21.7) -23.4% (-25;-21.7) -23.3% (-25.5;-21.7) p = 0.8 Free wall RV Sl (median, IQR) 27.7% (-30;-25.2) -27.6% (-29.3;-25.2%) -28.1% (-29.7;-25) -27.5 (-30.5;-25.4) p = 0.9

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