P987 Comprehensive systolic right ventricular longitudinal strain analysis in congenital heart disease patients with different right ventricular loading conditions

Abstract

Abstract Background Right ventricular (RV) function is recognized as a prognostic factor in congenital heart disease (CHD). Speckle tracking analysis might reveal subclinical systolic dysfunction. Accurate assessment of global (GLS) and regional strain measurements of the RV remain challenging. We previously introduced a novel four-view approach with all RV walls visualized in their long axis from one apical view using 2D multi-plane-transthoracic echocardiographic (TTE) iRotate mode. Aims To extensive evaluate GLS of the entire RV using iRotate echocardiography in CHD patients with different RV loading conditions compared with healthy subjects. Methods and Results One-hundred forty-two CHD patients with different RV loading conditions were recruited from the outpatient clinic and compared with 89 age, gender and BSA matched healthy controls. CHD patients were divided in 5 groups: 42 patients with volume overloaded (VO)RV (at least moderate pulmonary or tricuspid regurgitation (TR) and/or an atrium septum defect), 16 patients with pressure overloaded (PO) RV (defined as TR velocity > 2.8 m/s), 34 patients who met both criteria for volume and pressure overloaded RV (P + VO), 30 patients with systemic RV and 27 with normal RV loading conditions. TAPSE and Fractional area change (FAC%) were significantly lower in all CHD subgroups vs healthy controls (p < 0.05). Within the CHD group, TAPSE, FAC% and TDI S` did not differentiate systemic RV from PO RV, whereas RV function was significantly better in RV VO and RV VO + PO compared with systemic RV. GLS was significantly lower in patients with CHD compared with healthy subjects. Within the CHD groups, GLS values of systemic RV were lower (p < 0.05), but no significant difference could be observed between the other subpulmonic RV loading conditions (Figure). Conclusion Comprehensive RV function analysis reveals decreased RV function in all CHD subgroups compared with healthy subjects. GLS showed RV systolic function to be the worst in the systemic RV but however could not differentiate between subpulmonic RV groups confirming the load independent functional analysis capacity of GLS. Abstract P987 Figure.