Comparison of two-dimensional strain and tissue Doppler imaging based right ventricular longitudinal systolic function in normal subjects and patients with pulmonary arterial hypertension

Abstract

Objective To assess right ventricular systolic function in normal subjects and patients with pulmonary arterial hypertension (PAH) by using 2-dimensional strain (2DS) and tissue Doppler imaging(TDI), and to investigate the feasibility of 2DS for quantitative assessment of myocardial longitudinal systolic function. Methods Longitudinal peak systolic velocity (V), peak systolic strain(e), peak systolic strain rate(SRS) were measured in right ventricular free wall for basal,mid and apical segment in 42 patients with PAH and 31 healthy controls by 2DS and TDI from the apical 4-chamber view and compared between 2DS and TDI. Results ①Compared with controls,e and SRS of the mid segment of the right ventricular free wall by TDI were significantly reduced in patients with PAH (P 0.05). e and SRS of all segments by 2DS were markedly reduced in patients with PAH (all P 0.05). ②In normal subjects,values(V,e,SRS) of basal and apical segment of right ventricular free wall measured by 2DS were significantly different from those by TDI (P 0.05); In patients with PAH, values (V, e, SRS) of apical segment of right ventricular free wall by 2DS were significantly different from those by TDI,values of basal and mid segment by 2DS and TDI were not significantly different. ③ There were good correlations between 2DS and TDI in patients with PAH (r = 0.406～0.760, P<0.05 for all). Conclusions Right ventricular longitudinal systolic function in patients with PAH was decreased, 2DS is more accurate and objective than TDI in assessment of right ventricular longitudinal systolic function. Key words: Echocardiography; Ventricular function, right; Two-dimensional strain imaging; Hypertension, pulmonary