Abstract
BackgroundRight ventricular (RV) three-dimensional (3D) strains can be measured using novel 3D RV analytical software (ReVISION). Our objective was to investigate the prognostic value of RV 3D strains.MethodsWe retrospectively selected patients who underwent both 3D echocardiography (3DE) and cardiac magnetic resonance from January 2014 to October 2020. 3DE datasets were analyzed with 3D speckle tracking software and the ReVISION software. The primary end point was a composite of cardiac events, including cardiac death, heart failure hospitalization, or ventricular tachyarrhythmia.Results341 patients were included in this analysis. During a median of 20 months of follow-up, 49 patients reached a composite of cardiac events. In univariate analysis, 3D RV ejection fraction (RVEF) and three 3D strain values [RV global circumferential strain (3D RVGCS), RV global longitudinal strain (3D RVGLS), and RV global area strain (3D RVGAS)] were significantly associated with cardiac death, ventricular tachyarrhythmia, or heart failure hospitalization (Hazard ratio: 0.88 to 0.93, p < 0.05). Multivariate analysis revealed that 3D RVEF, three 3D strain values were significantly associated with cardiac events after adjusting for age, chronic kidney disease, and left ventricular systolic/diastolic parameters. Kaplan-Meier survival curves showed that 3D RVEF of 45% and median values of 3D RVGCS, 3D RVGLS, and 3D RVGAS stratified a higher risk for survival rates. Classification and regression tree analysis, including 22 clinical and echocardiographic parameters, selected 3D RVEF (cut-off value: 34.5%) first, followed by diastolic blood pressure (cut-off value: 53 mmHg) and 3D RVGAS (cut-off value: 32.4%) for stratifying two high-risk group, one intermediate-risk group, and one low-risk group.ConclusionsRV 3D strain had an equivalent prognostic value compared with 3D RVEF. Combining these parameters with 3D RVEF may allow more detailed stratification of patient's prognosis in a wide array of cardiac diseases.
Highlights
For the last decade, the right ventricle has gained increasing attention for morphological and functional assessment
Tricuspid annular plane systolic excursion (TAPSE), right ventricular (RV) fractional area change, systolic tricuspid annular velocity (RVs’), and longitudinal strains are commonly used for assessment of RV function with two-dimensional (2D) and tissue Doppler echocardiography, these measurements do not cover all aspects of RV function and 2D echocardiographic assessment of RV function has several limitations due to the complex morphology of the right ventricle
Of 432 patients enrolled in the cardiac magnetic resonance (CMR) database from January 2014 to October 2020, 341 patients were included as a final study population (Figure 2)
Summary
The right ventricle has gained increasing attention for morphological and functional assessment. Tricuspid annular plane systolic excursion (TAPSE), right ventricular (RV) fractional area change, systolic tricuspid annular velocity (RVs’), and longitudinal strains are commonly used for assessment of RV function with two-dimensional (2D) and tissue Doppler echocardiography, these measurements do not cover all aspects of RV function and 2D echocardiographic assessment of RV function has several limitations due to the complex morphology of the right ventricle. The ReVISION (Right VentrIcular Separate wall motion quantificatiON) software was recently introduced, enabling comprehensive 3D echocardiographic analysis of the right ventricle [7]. With this method, strain values such as 3D RV global circumferential strain (RVGCS), 3D RV global longitudinal strain (RVGLS), and 3D RV global area strain (RVGAS) could be calculated from 3DE datasets. Our objective was to investigate the prognostic value of RV 3D strains
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
