Right ventricular mechanics using a novel comprehensive three-view echocardiographic strain analysis in a normal population.
BACKGROUND
Although quantitative right ventricular (RV) strain analysis may be useful in congenital and acquired heart disease populations with RV failure, a comprehensive, standardized approach is lacking. An 18-segment RV strain analysis obtained from three standardized RV apical echocardiographic images was used to determine the feasibility, normal values, and reproducibility of the method in normal adults.


METHODS
Forty healthy, prospectively enrolled volunteers with no cardiac histories and normal QRS durations underwent echocardiography optimized for strain analysis including three RV apical views. Two-dimensional speckle-tracking longitudinal strain analysis was performed using EchoPAC software. Eleven retrospectively identified subjects with RV disease were included as a pilot population. All had been imaged using the same protocol including the three RV apical views.


RESULTS
All control subjects had normal anatomic morphology and function by echocardiography. Feasibility of the RV strain analysis was good (adequate tracking in 696 of 720 segments [97%]). RV global peak systolic strain was -23 ± 2%. Peak strain was highest in the RV free wall and lowest in the septum. Dyssynchrony indices demonstrated no dyssynchrony using left ventricular criteria. Reproducibility of most strain measures was acceptable. This methodology identified important disease not seen in the four-chamber apical view alone in the pilot population of 11 patients with RV disease. Strain patterns and values were different from those in the control population, indicating that differences do exist from normal.


CONCLUSIONS
Eighteen-segment RV strain analysis is feasible, with strain measures falling into discrete ranges in this normal population. Those with RV disease illustrate the potential utility of this approach. These data indicate that this model can be used for more detailed studies evaluating abnormal RV populations, in which its full potential can be assessed.
['Forsha|Daniel|D|', 'Risum|Niels|N|', 'Kropf|P Andrea|PA|', 'Rajagopal|Sudarshan|S|', 'Smith|P Brian|PB|', 'Kanter|Ronald J|RJ|', 'Samad|Zainab|Z|', 'Sogaard|Peter|P|', 'Barker|Piers|P|', 'Kisslo|Joseph|J|']
D000293:Adolescent D000328:Adult D000465:Algorithms D019560:Echocardiography, Three-Dimensional D055119:Elastic Modulus D054459:Elasticity Imaging Techniques D005240:Feasibility Studies D005260:Female D006352:Heart Ventricles D006801:Humans D007089:Image Enhancement D007090:Image Interpretation, Computer-Assisted D008297:Male D008875:Middle Aged D012016:Reference Values D015203:Reproducibility of Results D012680:Sensitivity and Specificity D016278:Ventricular Function, Right D055815:Young Adult
Right Strain Echocardiography Function Ventricle