Abstract

Cardiovascular magnetic resonance based tissue tracking (CMR-TT) was reported to provide detailed insight into left ventricular mechanical features. However, inadequate knowledge of the right ventricle (RV) mechanical deformation has been acquired by this advanced technique so far. It was the aim of this study to establish reference values of RV free wall (RVFW) global, regional and segmental longitudinal peak strain and strain rate (LS and LSR), and to investigate the gender- and age-related difference as well as the base-to-apex gradient of RVFW-LS and LSR with CMR-TT. 150 healthy volunteers (75 males/females) were retrospectively and continuously recruited and subdivided into three age groups (G20–40, G41–60 and G61–80). RVFW global, regional (basal, middle-cavity and apical) and segmental LS (GLS, RLS, SLS) along with systolic and diastolic LSR were generated by post-hoc CMR-TT analysis of standard steady-state free precession long-axis four-chamber view cine images acquired at 1.5T field strength. The reference value of myocardial RVFW-GLS was − 24.9 ± 5.2%. We found that females showed more negative GLS than males except in the youngest group, and no age-related difference of GLS was observed in both gender groups. RLS and SLS presented with the same age-related tendency as GLS. The basal and middle-cavity LS were similar between each other and significantly larger than apical LS. RVFW-GLSR resulted as − 1.73 ± 0.58 s−1 and 1.69 ± 0.65 s−1 during systolic and diastolic phases, respectively. The diastolic GLSR of males tended to decline with the ageing and was significantly lower than that of females in G61–80 group. Regional and segmental LSR showed significant gender-related differences in certain basal and apical region/segments without any age-related effects. CMR-TT overcomes the difficulty in measuring RV global and segmental deformation. The establishment of the vendor-, gender- and segment-specific reference values of RVFW-LS and LSR is essential for the rapid and efficient utilization of CMR-TT modality in the clinical routine.

Highlights

  • There is strong evidence that impairment of right ventricular (RV) function plays an important role in developing myocardial diseases [1, 2], including cardiomyopathies, and congenital, ischemic, valvular and pulmonary heart diseases [3,4,5]

  • Myocardial strain analysis has been reported as a sensitive surrogate to ejection fraction (EF) to detect subclinical alterations of myocardial function [9, 10], with remarkable diagnostic and prognostic value in heart failure, pulmonary hypertension and ischemic heart disease [5, 8, 11, 12]

  • Average age resulted as 49.8 ± 17.3 years old, without a significant difference between males and females in each age group

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Summary

Introduction

There is strong evidence that impairment of right ventricular (RV) function plays an important role in developing myocardial diseases [1, 2], including cardiomyopathies, and congenital, ischemic, valvular and pulmonary heart diseases [3,4,5]. RV ejection fraction (EF) derived from the volumetric changes of the RV between end-diastole (EDV) and end-systole (ESV) phases is regarded as a powerful and independent parameter to evaluate RV global contractile function, but cannot provide details on global or regional myocardial deformation. Myocardial strain analysis has been reported as a sensitive surrogate to EF to detect subclinical alterations of myocardial function [9, 10], with remarkable diagnostic and prognostic value in heart failure, pulmonary hypertension and ischemic heart disease [5, 8, 11, 12]

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