Right Ventricular Longitudinal Strain Rate Research Articles

Assessment of immediate effects of percutaneous balloon mitral valvuloplasty on right ventricular and pulmonary functions in severe rheumatic mitral stenosis patients using speckle tracking echocardiography and spirometry.

Introduction: The current study was sought to assess the immediate effect of percutaneous balloonmitral valvuloplasty (PBMV) on right ventricular (RV) and pulmonary functions using speckle tracking echocardiography (STE) and spirometry respectively. Methods: Two-dimensional speckle tracking and doppler studies for strain and strain rate imaging of RV were performed before PBMV, after 48h and 15 days of PBMV using echocardiography and spirometry. Mitral valve area, peak and mean mitral valve transannular pressure gradients, late filling velocities,Wilkins score, Systolic pulmonary artery pressure, TAPSE, RV end-diastolic and end-systolic areas,RV fractional area change and Tei index were measured. Results: There was a significant rise in peak RV global longitudinal strain (GLS) from baseline to48h post PBMV and at 15 days post PBMV. Segmental RV strain at basal septum, mid septum,apical septum and basal RV free wall showed considerable improvement from baseline to 48h post PBMV and 15 days post PBMV. RV longitudinal strain rate parameters did not show significant improvement after PBMV and remained low at follow-up. Post PBMV all patients showed restrictive features on pulmonary function test. The mean FEV1 (% predicted), mean FVC (% predicted), mean PEFR improved from baseline to 48h PBMV and 15 days post PBMV. Though the mean FEV1/FVC increased post PBMV at 15 days follow-up, but it was statistically insignificant. Conclusion: RV performance in MS was decreased mainly due to increase in RV after load which improves after PBMV. Patients with severe MS have impaired pulmonary function which is of restrictive type and successful PBMV improves pulmonary function.

Severe pulmonary regurgitation in adolescents with tetralogy of Fallot leads to increased longitudinal strain

ObjectivesPostoperative patients with tetralogy of Fallot (TOF) are often compromised by chronic pulmonary regurgitation and chronic right ventricular volume load. We sought to determine whether pulmonary regurgitation (PR) would affect right and left ventricle (RV and LV) strain.Materials and methodsThis cross-sectional analysis included 40 patients who had TOF with surgical repair, with an average follow-up period of 11.8 ± 3.0 years. Altogether, 44 healthy volunteers with similar age and gender distribution were recruited. A cardiovascular magnetic resonance imaging study with feature tracking analysis was performed on all patients and controls.ResultsRV peak longitudinal strain was increased in TOF patients with PR > 30 ml/m2 when compared to those with PR < 30 ml/m2 (− 22.5% ± 2.7% vs − 19.7% ± 3.5%, p = 0.018) and controls (p = 0.007). PR volume correlated with peak RV longitudinal strain (R = − 0.37, p = 0.030) and peak RV longitudinal strain rate (systolic: R = 0.37, p = 0.03; diastolic: R = 0.39, p = 0.021). The peak RV circumferential strain, from base to apex, increased more than in healthy controls (apex-base difference 7.6% ± 4.2% vs 3.3% ± 2.4%, p < 0.0001).ConclusionsPediatric patients with TOF and a severe pulmonary regurgitation show an enhanced longitudinal strain when compared to patients with milder regurgitation or to control subjects. In addition, mean RV circumferential strain of the patients is significantly enhanced compared to healthy individuals.

Effect of acute volume overload on echocardiographic indices of right ventricular function and dyssynchrony assessed by use of speckle tracking echocardiography in healthy dogs.

OBJECTIVE To determine the relationship between acute volume overload and echocardiographic indices of right ventricular (RV) function and dyssynchrony in healthy dogs. ANIMALS 7 healthy Beagles. PROCEDURES Right heart catheterization and echocardiography were performed in 7 healthy anesthetized Beagles at baseline and after induction of volume overload. Volume overload was induced by IV infusion of lactated Ringer solution (150 mL/kg/h for 90 minutes). Echocardiographic indices of RV function, including peak velocity of systolic tricuspid annular motion, tricuspid annulus plane systolic excursion, fractional area change, RV Tei index, RV longitudinal strain (RVLS), and systolic RV longitudinal strain rate (RVLSR), were obtained by use of speckle tracking echocardiography (STE). In addition, SD of the systolic shortening time of the right ventricle for the 6 segments (RV-SD6) was determined with STE. RESULTS Volume overload significantly increased the RV end-diastolic pressure, compared with the baseline value. Echocardiographic indices of RV function, except for septal RVLSR, were significantly enhanced by volume overload. In contrast, RV-SD6 did not change with volume overload. Although echocardiographic indices of RV function, except for septal RVLSR, were correlated with RV end-diastolic pressure, RV-SD6 was not correlated. CONCLUSIONS AND CLINICAL RELEVANCE Echocardiographic indices of RV function, including RVLS and RVLSR, were affected by acute short-term volume overload. Therefore, results for assessment of RV function by use of STE in dogs with clinical conditions associated with right-sided chronic volume overload, such as tricuspid and pulmonic regurgitation, should be interpreted with caution.

Influence of the body position on the systolic speckle-tracking derived left and right ventricular function indexes of ultra-trailers

Preload is prone to vary during ultra long duration exercise (ULDE) and this can complicate the analysis of left ventricular (LV) and right ventricular (RV) function under such conditions. We studied LV and RV contractility indexes while preload conditions were changed. Twenty-two healthy male amateur ultra trailers (mean age 47) underwent serial echocardiographic assessments in three positions at rest: left-side decubitus in the standard position (P1), head-up and legs down (P2) then in the Trendelenburg position (P3). Heart rate (HR) and systolic blood pressure (SBP) were monitored. Preload was estimated by the biplane LV end diastolic volume (LV-EDV). Statistical analyses were conducted using repeated measures ANOVA. HR and SBP did not vary. LV-EDV was significantly greater in P3 than in P2 ( P = 0.004) and in P1 ( P = 0.001). LV Radial Peak Strain (LV-RPS) and LV Circumferential Peak Strain (LV-CPS) did not change. LV Longitudinal Peak Strain (LV-LPS) was greater in P3 than in P2 ( P < 0.01) and greater in P1 than in P2 ( P < 0.001). RV Longitudinal Peak Srain (RV-LPS) was greater in P3 than in P2 ( P < 0.03). The LV Longitudinal Strain Rate (LV-LSR), the LV Circumferential Strain Rate (LV-CSR) and the RV Longitudinal Strain Rate (RV-LSR) were not modified by the change of body position ( Table 1 ). LV-LSR, LV-CSR and RV-LSR as well as LV-RPS and LV-CPS were not influenced by the body position. These latter ventricular indexes seem to be less preload dependent than LV-LPS and RV-LPS and may be favored when assessing LV and RV function during ULDE.

Speckle tracking for the assessment of fetal cardiac function

Speckle tracking for the assessment of fetal cardiac function