Reference Values of Right Atrial Longitudinal Strain Imaging by Two-Dimensional Speckle Tracking

Introduction: Right ventricle (RV) systolic function is an important determinant of cardiopulmonary outcomes in premature infants. Two-dimensional speckle tracking echocardiography (2DSTE) derived myocardial strain is a reliable measure of RV systolic function in premature infants, but lacks reference values for clinical application in premature infants. We aimed to determine the maturational (age- and weight- related) changes in RV strain to establish reference values in preterm infants from birth to one year corrected age (CA). Methods: RV peak global longitudinal strain (pGLS) and RV free wall longitudinal strain (FWLS) were measured in a prospective longitudinal study in 115 preterm infants (< 29 weeks at birth) at 24 and 72 hours of age (HOA), 32 and 36 weeks postmenstrual age (PMA), and one year (CA) by 2DTSE (GE EchoPac) from a RV-focus apical 4-chamber view using a validated protocol. Premature infants that developed chronic lung disease or had a hemodynamically significant PDA were excluded (n=65) from analysis for the reference values. Results: RV pGLS ranged from -16% at birth to -26% by one year CA and RV FWLS ranged from -18% at birth to -27% to one year CA in healthy preterm infants. RV pGLS and FWLS strain correlated with increasing weight (r=0.87, p < 0.001), PMA in weeks (r=0.85, p < 0.001; r=0.83, p < 0.001), but were independent of gestational age at birth (r=0.4, p=0.38; r=0.3, p=0.5). RV strain was significantly lower in preterm infants with bronchopulmonary dysplasia (p=0.004) at 32 and 36 weeks PMA, and one year CA (Figure). RV strain was independent of gender or need for mechanical ventilation. Conclusions: This study establishes reference values of RV global and free wall longitudinal strain and tracks their postnatal maturational changes in preterm infants. These measures increase from birth to one year CA and are linearly associated with increasing weight reflecting the postnatal cardiac growth as a contributor to the maturation of RV function.

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Second Trimester Ultrasound: Reference Values for Two-Dimensional Speckle Tracking–Derived Longitudinal Strain, Strain Rate and Time to Peak Deformation of the Fetal Heart

Journal of the American Society of Echocardiography ◽

10.1016/j.echo.2012.09.011 ◽

2012 ◽

Vol 25 (12) ◽

pp. 1333-1341 ◽

Cited By ~ 29

Author(s):

Livia Kapusta ◽

Gur Mainzer ◽

Zeev Weiner ◽

Lisa Deutsch ◽

Asaad Khoury ◽

...

Keyword(s):

Strain Rate ◽

Reference Values ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Fetal Heart ◽

Two Dimensional ◽

Second Trimester ◽

Time To Peak

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Assessment of inter-atrial, inter-ventricular, and atrio-ventricular interactions in tetralogy of Fallot patients after surgical correction. Insights from two-dimensional speckle tracking and three-dimensional echocardiography

Cardiology in the Young ◽

10.1017/s1047951114002108 ◽

2014 ◽

Vol 25 (7) ◽

pp. 1254-1262 ◽

Cited By ~ 6

Author(s):

Mohamed Abd El Rahman ◽

Tanja Raedle-Hurst ◽

Axel Rentzsch ◽

Hans-Joachim Schäfers ◽

Hashim Abdul-Khaliq

Keyword(s):

Ejection Fraction ◽

Tetralogy Of Fallot ◽

Left Atrial ◽

Speckle Tracking ◽

Longitudinal Strain ◽

Three Dimensional ◽

Right Atrial ◽

Two Dimensional ◽

Dimensional Echocardiography ◽

Three Dimensional Echocardiography

AbstractBackground: We aimed to assess biatrial size and function, interactions on atrial and ventricular levels, and atrio-ventricular coupling in patients after tetralogy of Fallot repair. Methods: A total of 34 patients with a mean age of 20.9±9 years, and 35 healthy controls, underwent two-dimensional speckle tracking echocardiography for ventricular and atrial strain measurements and real-time three-dimensional echocardiography to assess ventricular and atrial volumes. Results: When compared with controls, tetralogy of Fallot patients had significantly reduced right atrial peak atrial longitudinal strain (p<0.01), right atrial peak atrial contraction strain (p<0.01), right atrial ejection fraction (p<0.01), left atrial peak atrial longitudinal strain (p<0.01), left atrial peak atrial contraction strain (p<0.05), and left atrial ejection fraction (p<0.01). In the tetralogy of Fallot group, left ventricular ejection fraction was negatively related to the right ventricular end-systolic volume normalised to body surface area (r=−0.62, p<0.01). An association was found in patients between the right atrial peak longitudinal strain and mean right ventricular strain (r=0.64, p<0.01). In patients, the left atrial peak longitudinal strain correlated negatively with right atrial end-diastolic volume normalised to body surface area (r=−0.67, p<0.01), whereas the left atrial ejection fraction correlated weakly with left ventricular ejection fraction (r=0.41, p<0.05). Conclusions: In asymptomatic tetralogy of Fallot patients, biatrial dysfunction exists and can be quantified via two-dimensional speckle tracking echocardiography as well as real-time three-dimensional echocardiography. Different forms of interactions on atrial and ventricular levels are evident among such cohorts.

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