title: Association between right ventricular two-dimensional strain and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy.
abstract: OBJECTIVE
  To detect right ventricular myocardial function in dilated cardiomyopathy (DCM) using two-dimensional strain echocardiography (2DSE) and to evaluate the relationship between right ventricular dysfunction and response to cardiopulmonary exercise test (CPET).
  
  
  METHODS
  Seventy-five DCM patients (44 idiopathic and 31 ischemic) without clinical signs of right ventricular failure underwent standard echo, 2DSE analysis of right ventricle and bicycle CPET.
  
  
  RESULTS
  The two groups were comparable for clinical and standard two-dimensional echocardiographic and Doppler variables, except for right ventricular diameters that were mildly increased in patients with idiopathic DCM. Right ventricular global longitudinal strain (RV GLS) and regional peak myocardial right ventricular strain were significantly impaired in patients with idiopathic DCM compared with ischemic DCM (both P<0.001). A significant correlation was detectable among RV GLS and VO2 peak percentage (r= -0.65, P<0.0001), VE/VCO2 slope (r=0.35, P<0.01), maximum work rate percentage (r= -0.55, P<0.001) and peak circulatory power (r=0.53, P<0.001). These correlations with RV GLS remained significant even in multivariate analysis.
  
  
  CONCLUSIONS
  2DSE represents a promising noninvasive technique to assess right ventricular myocardial function in patients with DCM. Reduced right ventricular myocardial deformation is related to decreased ability to perform aerobic exercise and work rate, and to impaired ventilatory response.
authors.affiliation: Second University of Naples, Naples, Italy.
authors.forename: Gemma
authors.initials: G
authors.lastname: Salerno
authors.forename: Antonello
authors.initials: A
authors.lastname: D'Andrea
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
authors.forename: Raffaella
authors.initials: R
authors.lastname: Scarafile
authors.forename: Lucia
authors.initials: L
authors.lastname: Riegler
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Salvo
authors.forename: Rita
authors.initials: R
authors.lastname: Gravino
authors.forename: Enrica
authors.initials: E
authors.lastname: Pezzullo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Limongelli
authors.forename: Massimo
authors.initials: M
authors.lastname: Romano
authors.forename: Sergio
authors.initials: S
authors.lastname: Cuomo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pacileo
authors.forename: Pio
authors.initials: P
authors.lastname: Caso
authors.forename: Maria G
authors.initials: MG
authors.lastname: Russo
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D015150:Echocardiography, Doppler; D005080:Exercise Test; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D007558:Italy; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D015588:Observer Variation; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012123:Pulmonary Ventilation; D015203:Reproducibility of Results; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right