title: Timing and magnitude of regional right ventricular function: a speckle tracking-derived strain study of normal subjects and patients with right ventricular dysfunction.
abstract: BACKGROUND
  The aim of this study was to evaluate the timing and magnitude of global and regional right ventricular (RV) function by means of speckle tracking-derived strain in normal subjects and patients with RV dysfunction.
  
  
  METHODS
  Peak longitudinal systolic strain (PLSS) and time to PLSS in 6 RV segments (the basal, mid, and apical segments of the RV free wall and septum) were obtained in 100 healthy volunteers and 76 patients with RV dysfunction by tracking speckles inside the myocardium using grayscale images. Global PLSS and time to PLSS were based on the average of the 6 regional values.
  
  
  RESULTS
  There was a significant and close correlation between RV contractility as measured by PLSS and tricuspid annular plane systolic excursion (r = -0.83, P < .001). In normal subjects, PLSS was significantly greater in the free wall than in the septum (-28.7 + or - 4.1% vs -19.8 + or - 3.4%, P < .001), whereas time to PLSS was similar in the different regions of the right ventricle. In patients with RV dysfunction, global and regional PLSS was significantly less than in normal subjects (-13.7 + or - 3.6% vs -24.2 + or - 2.9%, P < .001), and a global PLSS cutoff value of -19% was helpful in distinguishing the two groups. Furthermore, time to PLSS in all of the RV septal segments and dispersion in RV contraction timing were significantly longer. Global PLSS in the patients with RV dysfunction was also significantly less in the presence of moderate to severe pulmonary hypertension (-12.7 + or - 3.6% vs -14.4 + or - 3.4%, P = .038).
  
  
  CONCLUSIONS
  Speckle tracking not only makes it possible to quantify global RV function but also illustrates the physiology of RV contraction and the pattern of activation at regional level. Speckle tracking-derived strain could become an important new means of assessing and following up patients with impaired RV function and increased pulmonary pressure.
authors.affiliation: Division of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland. a.meris@hotmail.com
authors.forename: Alessandra
authors.initials: A
authors.lastname: Meris
authors.forename: Francesco
authors.initials: F
authors.lastname: Faletra
authors.forename: Cristina
authors.initials: C
authors.lastname: Conca
authors.forename: Catherine
authors.initials: C
authors.lastname: Klersy
authors.forename: François
authors.initials: F
authors.lastname: Regoli
authors.forename: Julia
authors.initials: J
authors.lastname: Klimusina
authors.forename: Maria
authors.initials: M
authors.lastname: Penco
authors.forename: Elena
authors.initials: E
authors.lastname: Pasotti
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Pedrazzini
authors.forename: Tiziano
authors.initials: T
authors.lastname: Moccetti
authors.forename: Angelo
authors.initials: A
authors.lastname: Auricchio
mesh_terms: D000328:Adult; D000368:Aged; D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging*