Abstract
Background: Three-dimensional (3D) imaging has the potential to evaluate right ventricular (RV) function accurately because of its complex geometry. We have developed a dedicated 3D-speckle tracking imaging (STI) system for the right ventricle, and performed validation studies to assess the reliability of 3D-STI derived deformation data. Methods: In 9 anesthetized sheep, RV full volume data sets for 3D-STI were obtained using a 3D echocardiography system (Toshiba Medical Systems) simultaneously with sonomicrometry data at the baseline and during pulmonary artery (PA) banding at moderate and severe levels, and propranolol infusion. In 7 RV segments (basal and mid anterior, basal and mid lateral, basal and mid inferior, and outflow), area change ratio (ACR), longitudinal strain (LS), and circumferential strain (CS) were calculated with prototype 3D-STI software (Figures) and compared with those by sonomicrometry. Results: ACR by 3D-STI strongly correlated with sonomicrometry data (Y=0.78X-5.0, R=0.83, p<0.001). LS and CS also showed significant correlations between the modalities (LS; Y=0.78X-1.8, R=0.79, CS; Y=0.62X-2.9, R=0.77, p<0.001). In segmental analysis, all deformation data showed significant correlations in each segment. During PA banding, PA pressure increased at a moderate (48.4±8.4mmHg) and a severe level (53.9±8.5mmHg mmHg) compared to the baseline (22.5±4.6mmHg). In contrast, 3D-STI data had graded decreases at the baseline, moderate and severe levels (ACR; -32.5±8.3, -24.2±10.0, -16.1±10.9%, p<0.001, LS; -16.0±6.2, -9.5±6.8, -5.1±7.7%, p<0.001, CS; -16.3±5.4, -12.6±7.6, -9.3±7.3%, p=0.003). During propranolol infusion, RV dP/dt was significantly decreased compared to the baseline (807±287 vs. 535±199 mmHg/s, p=0.01), and 3D-STI data also reduced (ACR; -23.3±7.7, LS; -10.4±5.8, CS; -11.5±5.4, p<0.05 vs. baseline). Conclusions: The newly developed 3D-STI system is a reliable modality for RV function analysis.
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