scholarly journals Three-dimensional versus two-dimensional derived strain echocardiography for assessing right ventricular myocardial deformation in patients with chronic left ventricular heart failure: A proof-of-concept study

2020 ◽  
Author(s):  
Fei Gao ◽  
Chong Liu ◽  
Qiang Guo ◽  
Shuang-quan Jiang ◽  
Zhen-zhen Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Three Dimensional ◽  
Strain Analysis ◽  
Free Wall ◽  
Two Dimensional ◽  
Control Subjects ◽  
Dimensional Echocardiography

Abstract Background A novel three-dimensional echocardiography (3DE)-derived strain analysis software specialized for right ventricular (RV) monitoring is emerging that could definitely evaluate RV free wall and interventricular septum longitudinal strain. The aim of this study was to compare the diagnostic performance in evaluating RV function between 3DE and two-dimensional echocardiography (2DE)-derived longitudinal strain. Methods Echocardiographic examinations were performed in 82 patients with RV dysfunction associated with chronic left-sided heart failure and 40 control subjects. RV dysfunction was defined as a 3DE-derived RV ejection fraction (EF) <45%. Both 2DE and 3DE-derived strain analyses were performed in all the patients to measure the longitudinal strain of RV. Results 3DE-derived peak systolic longitudinal strain of RV free wall (RV-fwLS) was significantly lower in patients with RV dysfunction compared to control subjects (-14.0±4.1 vs. -26.7±4.7%; p<0.001), and it correlated well with cardiac magnetic resonance-derived RVEF (r=0.74, p<0.001). On receiver operator characteristic analysis, a 3DE-derived RV-fwLS cutoff value of >-21.1% was most useful in identifying patients at higher risk of RV dysfunction (sensitivity: 90% and specificity: 85%), also higher than 2DE-derived strain parameters. Additionally, RV dysfunctional patients with pulmonary hypertension (PH) had significantly reduced 3DE-derived RV-fwLS value than the subgroup without PH (-13.1±3.8 vs. -15.0±4.2; p<0.05). Conclusion Assessment of RV myocardial function by 3DE-derived longitudinal strain is better than 2DE in identifying patients with impaired RV systolic function. 3DE-derived strain analysis for RV should be considered as a complementary tool for assessing RV systolic function in terms of accuracy.

scholarly journals Three-dimensional versus two-dimensional derived strain echocardiography for assessing right ventricular myocardial deformation in patients with chronic left ventricular heart failure: A proof-of-concept study

2020 ◽  
Author(s):  
Fei Gao ◽  
Chong Liu ◽  
Qiang Guo ◽  
Shuang-quan Jiang ◽  
Zhen-zhen Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Three Dimensional ◽  
Strain Analysis ◽  
Free Wall ◽  
Two Dimensional ◽  
Control Subjects ◽  
Dimensional Echocardiography ◽  
Rv Function

Abstract Background: A novel three-dimensional echocardiography (3DE)-derived strain analysis software specialized for right ventricular (RV) monitoring is emerging that could definitely evaluate RV free wall and interventricular septum longitudinal strain. The aim of this study was to compare the diagnostic performance in evaluating RV function between 3DE and two-dimensional echocardiography (2DE)-derived longitudinal strain. Methods: Echocardiographic examinations were performed in 82 patients with RV dysfunction associated with chronic left-sided heart failure and 40 control subjects. RV dysfunction was defined as a 3DE-derived RV ejection fraction (EF) <45%. Both 2DE and 3DE-derived strain analyses were performed in all the patients to measure the longitudinal strain of RV. Results: 3DE-derived peak systolic longitudinal strain of RV free wall (RV-fwLS) was significantly lower in patients with RV dysfunction compared to control subjects (-14.0±4.1 vs. -26.7±4.7%; p<0.001), and it correlated well with cardiac magnetic resonance-derived RVEF (r=0.74, p<0.001). On receiver operator characteristic analysis, a 3DE-derived RV-fwLS cutoff value of >-21.1% was most useful in identifying patients at higher risk of RV dysfunction (sensitivity: 90% and specificity: 85%), also higher than 2DE-derived strain parameters. Additionally, RV dysfunctional patients with pulmonary hypertension (PH) had significantly reduced 3DE-derived RV-fwLS value than the subgroup without PH (-13.1±3.8 vs. -15.0±4.2; p<0.05). Conclusion：Assessment of impaired RV systolic function by 3DE-derived longitudinal strain is better than 2DE in patients with chronic left-sided heart failure. 3DE-derived strain analysis specialized for RV should be considered as a complementary tool for assessing RV function.

scholarly journals Three-dimensional versus two-dimensional derived strain echocardiography for assessing right ventricular myocardial deformation in patients with chronic left ventricular heart failure: A proof-of-concept study

2020 ◽  
Author(s):  
Fei Gao ◽  
Chong Liu ◽  
Qiang Guo ◽  
Shuang-quan Jiang ◽  
Zhen-zhen Wang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Longitudinal Strain ◽  
Three Dimensional ◽  
Strain Analysis ◽  
Left Ventricular ◽  
Free Wall ◽  
Two Dimensional ◽  
Dimensional Echocardiography ◽  
Rv Function

Abstract Background: A novel three-dimensional echocardiography (3DE)-derived strain analysis software specialized for right ventricular (RV) monitoring is emerging that could definitely evaluate RV free wall and interventricular septum longitudinal strain. The aim of this study was to compare the diagnostic performance in evaluating RV function between 3DE and two-dimensional echocardiography (2DE)-derived longitudinal strain.Methods: Echocardiographic examinations were performed in 82 patients with RV dysfunction associated with chronic left-sided heart failure and 40 control subjects. RV dysfunction was defined as a 3DE-derived RV ejection fraction (EF) <45%. Both 2DE and 3DE-derived strain analyses were performed in all the patients to measure the longitudinal strain of RV.Results: 3DE-derived peak systolic longitudinal strain of RV free wall (RV-fwLS) was significantly lower in patients with RV dysfunction compared to control subjects (-14.0±4.1 vs. -26.7±4.7%; p<0.001), and it correlated well with cardiac magnetic resonance-derived RVEF (r=0.74, p<0.001). On receiver operator characteristic analysis, a 3DE-derived RV-fwLS cutoff value of >-21.1% was most useful in identifying patients at higher risk of RV dysfunction (sensitivity: 90% and specificity: 85%), also higher than 2DE-derived strain parameters. Additionally, RV dysfunctional patients with pulmonary hypertension (PH) had significantly reduced 3DE-derived RV-fwLS value than the subgroup without PH (-13.1±3.8 vs. -15.0±4.2; p<0.05).Conclusion：Assessment of impaired RV systolic function by 3DE-derived longitudinal strain is better than 2DE in chronic left-sided heart failure patients with left ventricular EF <45%. 3DE-derived strain analysis specialized for RV should be considered as a complementary tool for assessing RV function.

scholarly journals Comprehensive Echocardiographic Assessment of the Right Ventricular Performance: beyond TAPSE and Fractional Area Change

2020 ◽  
Vol 25 ◽  
pp. 4067
Author(s):  
E. Surkova ◽  
A. Kovács
Keyword(s):  
Right Ventricular ◽  
Systolic Function ◽  
Imaging Modality ◽  
Three Dimensional ◽  
Two Dimensional ◽  
Ventricular Performance ◽  
First Choice ◽  
Dimensional Echocardiography ◽  
Three Dimensional Echocardiography ◽  
The Right

Right ventricular (RV) performance is an important predictor of adverse events and mortality in patients with cardiovascular diseases. Echocardiography is the first-choice imaging modality for the assessment of RV systolic function, however conventional two-dimensional echocardiographic parameters have important limitations and under specific conditions poorly correlate with the gold-standard imaging modality, cardiac magnetic resonance. Recent advances in novel echocardiography techniques, including three-dimensional echocardiography and two-dimensional speckle-tracking echocardiography opened new era in RV imaging enabling more accurate and reproducible assessment of RV performance thus providing deeper insight into the pathophysiology of this intriguing cardiac chamber. In this comprehensive review authors summarize the state-of-the-art echocardiographic approach to the assessment of the RV systolic function with specific emphasis on modern techniques, their advantages, limitations and pitfalls in the various clinical settings.

Right ventricular systolic function in severe tricuspid regurgitation: prognostic relevance of longitudinal strain

2021 ◽  
Author(s):  
Francesco Ancona ◽  
Francesco Melillo ◽  
Francesco Calvo ◽  
Nadia Attalla El Halabieh ◽  
Stefano Stella ◽  
...  
Keyword(s):  
Heart Failure ◽  
Right Ventricular ◽  
Tricuspid Regurgitation ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Global Longitudinal Strain ◽  
Clinical Signs ◽  
Strain Analysis ◽  
Severe Tricuspid Regurgitation

Abstract Aims  The aim of this study is to analyse the prognostic implications of right ventricular (RV) dysfunction as detected by strain analysis in patients with severe tricuspid regurgitation (TR). The evaluation of RV systolic function in presence of severe TR is of paramount importance for operative risk stratification; however, it remains challenging, as conventional echocardiographic indexes usually lead to overestimation. Methods and results We enrolled 250 consecutive patients with severe TR referred to our centre. Baseline clinical and echocardiographic data and follow-up outcomes were collected. Patients were predominantly female, with multiple cardiovascular risk factors and comorbidities, history of heart failure, and atrial fibrillation. Most of them had presented with clinical signs of RV heart failure (RVHF) and advanced New York Heart Association class. The RV strain analysis [both RV free wall longitudinal strain (RVFWLS) and RV global longitudinal strain (RVGLS)] reclassified ∼42–56% of patients with normal RV systolic function according to conventional parameters in patients with impaired RV systolic function. RVFWLS ≤17% (absolute values, AUC: 0.66, P = 0.002) predicted the presence of RVHF [odds ratio (OR) 0.93, P = 0.01]. At follow-up, patients with RVFWLS &gt;14% (absolute values, AUC: 0.70, P = 0.001, sensitivity 72%, specificity 54%) showed a better survival (P = 0.01). Conclusion Different ranges of RVFWLS have different implications in patients with severe TR, allowing to identify a preclinical and a clinical window, with correlations to RVHF and survival.

scholarly journals Assessment of Biventricular Function in Clinically Well Pediatric Heart Transplantation Patients by Three-dimensional Speckle Tracking Echocardiography

2020 ◽  
Author(s):  
Qing Lv ◽  
Meng Li ◽  
He Li ◽  
Chun Wu ◽  
Nianguo Dong ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Three Dimensional ◽  
Free Wall ◽  
Ischemic Time ◽  
Biventricular Function ◽  
Pediatric Heart Transplantation

Abstract Background Studies on pediatric heart transplantation (HTx) are uniquely challenging because pediatric HTx center volumes are generally low. And, the biventricular function plays an important role in the prognosis of pediatric HTx. The primary aim of our study was to evaluate biventricular function of pediatric HTx by three-dimensional speckle tracking echocardiography(3D-STE). Methods We enrolled 30 clinically well pediatric HTx patients and 30 sex- and age- matched healthy controls. All subjects underwent comprehensive echocardiographic examinations. Left ventricular (LV) global longitudinal strain (GLS), global circumferential strain (GCS), LV and right ventricular (RV) ejection fraction (EF) and RV longitudinal strain (RVLS) of free wall and septum were acquired by 3D-STE. And the correlations between strains and clinical data were explored. Results Compared with controls, LV GLS was decreased in pediatric HTx patients (P<0.05), while LV GCS and LVEF showed no difference. RVEF, RVLS (free wall) and RVLS (septum) in HTx group were diminished (P<0.05), but RVEF was still in normal range. Cold ischemic time was correlated inversely with LV GLS (β=-0.401, P<0.05). The mean pulmonary artery pressure (β=0.447, P<0.05) and postoperative tricuspid regurgitation pressure (β=0.607, P<0.05) were associated with RVLS (free wall). Conclusion Biventricular longitudinal systolic function rather than global systolic function was impaired after HTx. 3D STE may be able to evaluate the ventricular function better. Prolonged ischemic time leads to impaired LV longitudinal systolic function in pediatric HTx patients. It’s interesting that in HTx patients, it shows compensatory enhancement due to increased pulmonary vascular resistance.

scholarly journals Preoperative Right Ventricular Free‐Wall Longitudinal Strain as a Prognosticator in Isolated Surgery for Severe Functional Tricuspid Regurgitation

2021 ◽  
Author(s):  
Minkwan Kim ◽  
Hyun‐Jung Lee ◽  
Jun‐Bean Park ◽  
Jihoon Kim ◽  
Seung‐Pyo Lee ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Tricuspid Regurgitation ◽  
Prognostic Value ◽  
Longitudinal Strain ◽  
Systolic Function ◽  
Unplanned Readmission ◽  
Free Wall ◽  
Right Ventricular Free Wall ◽  
Surgical Timing ◽  
End Point

Background Severe tricuspid regurgitation (TR) should be intervened before the development of irreversible right ventricular (RV) dysfunction. However, current guidelines do not provide criterion related to RV systolic function to guide optimal surgical timing. We investigated the prognostic value of RV longitudinal strain in patients undergoing isolated surgery for severe functional TR. Methods and Results We enrolled 115 consecutive patients (aged 62±10 years; 23.5% men; 62.6% [n=72] with previous left‐sided valve surgery) who underwent isolated surgery for severe functional TR at 2 tertiary centers. Preoperative clinical and echocardiographic parameters, including RV free‐wall longitudinal strain (RVFWSL), were collected. The primary end point was a composite of cardiac death and unplanned readmission attributable to cardiovascular causes 5 years after surgery. Forty patients (34.8%) reached the primary end point during 333 person‐years of follow‐up. There were 11 cardiac deaths and 34 unplanned readmissions attributable to cardiovascular causes, with 5 patients experiencing both. An absolute preoperative RVFWSL <24% was associated with the primary end point (hazard ratio, 2.30; 95% CI, 1.22–4.36; P =0.011), independent of clinical risk factors, including European System for Cardiac Operative Risk Evaluation II and hemoglobin levels. Meanwhile, other conventional echocardiographic measures of RV systolic function were not significant. The addition of an absolute RVFWSL <24% provided incremental prognostic value to the clinical model for predicting the primary end point. Conclusions Preoperative RVFWSL as an indicator of RV dysfunction was an independent prognosticator in patients undergoing isolated surgery for severe functional TR. Thus, preoperative RVFWSL could help determine the optimal surgical timing for severe functional TR.

Abstract 14760: Right Ventricular Function in Preterm Neonates: Reference Values for Longitudinal Strain by Two-dimensional Speckle Tracking Echocardiography From Birth to One Year of Life

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Philip T Levy ◽  
Meghna D Patel ◽  
Mark R Holland ◽  
Timothy J Sekarski ◽  
Amit Mathur ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Premature Infants ◽  
Reference Values ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Systolic Function ◽  
Free Wall ◽  
Two Dimensional ◽  
One Year

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.

scholarly journals 1187 Evaluation of left and right ventricular functions with 3D speckle tracking in patients with mitral stenosis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
O Seckin ◽  
S Unlu ◽  
G Tacoy
Keyword(s):  
Right Ventricular ◽  
Mitral Stenosis ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Three Dimensional ◽  
Left Ventricular ◽  
Control Group ◽  
Free Wall ◽  
Significant Difference

Abstract Background The function of both ventricles have been suggested to be affected in patients with mitral stenosis. In this study, it was aimed to investigate deformation properties of right (RV) and left ventricles (LV) in mild and moderate rheumatic mitral stenosis (MS) patients with three-dimensional speckle tracking echocardiography (3D-STE). Methods A total of 60 patients were included in the study (20 patients with mild MS diagnosis, 20 patients with moderate MS diagnosis and 20 healthy volunteers). Three-dimensional echocardiography datasets were obtained for both ventricles in all patients. An example for RV assessment is shown in Figure 1. LV global longitudinal strain (GLS), LV torsion, RV free wall (FW) LS and interventricular septal (IVS) LS measurements were analyzed. Results The LV ejection fraction (EF), RV fractional area change and tricuspid annular plane systolic excursion values were statistically similar and in the normal range. The LV GLS measurements were significantly different among the groups by being highest in the control group and least in the moderate stenosis group (ANOVA,p &lt; 0.001) (Table 1). Patients with MS showed higher torsional values, correlated with MS severity (ANOVA,p &lt; 0.001) (Table 1). IVS LS, RVFW LS values obtained by RV analysis also differed significantly among groups. The FW-GLS values only showed significant difference between the control group and moderate MS group (Table 1). Conclusion Patients with mitral stenosis showed lower LV-GLS and higher LV torsion values. Although the LV GLS is affected; the LV EF was detected to be normal due to increase in LV torsion. RV deformation indices showed signıficant decrease in correlation with the severity of the mitral stenosis. In conclusion, our data suggest that subclinical LV and RV systolic dysfunction is present in mild-moderate MS patients and this dysfunction can be detected by 3D-STE. Table 1 Parameters Control group Mild MS Moderate MS P LV GLS (%) 23.3 ± 2.08 18.9 ± 1.3 17.5 ± 1.8 &lt;0.001 LV torsion 1.5 ± 0.6 2.1 ± 0.6 2.6 ± 0.5 &lt;0.001 IVS LS (%) 23 ± 3.0% 20 ± 2.6 17.1 ± 2.9 &lt;0.001 RV FW LS (%) 25.4 ± 5 22.7 ± 3.2 21.1 ± 4.8 &lt;0.001 FW; free-wall, GLS; global longitudinal strain, IVS; interventricular septum, LV; left ventricular, RV; right ventricular Abstract 1187 Figure 1

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