title: Nonvolumetric echocardiographic indices of right ventricular systolic function: validation with cardiovascular magnetic resonance and relationship with functional capacity.
abstract: OBJECTIVE
  Right ventricular (RV) systolic function as measured by right ventricular ejection fraction (RVEF) has long been recognized as an important predictor of outcome in heart failure patients. The echocardiographic measurement of RV volumes and RVEF is challenging, however, owing to the unique geometry of the right ventricle. Several nonvolumetric echocardiographic indices of RV function have demonstrated prognostic value in heart failure. Comparison studies of these techniques with each other using RVEF as a benchmark are limited, however. Furthermore, the contribution of these various elements of RV function to patient functional status is uncertain. We therefore aimed to: (1) Determine which nonvolumetric echocardiographic index correlates best with RVEF as determined by cardiac magnetic resonance (CMR) imaging (the accepted gold standard measure of RV systolic function) and (2) Ascertain which echocardiographic index best predicts functional capacity.
  
  
  METHODS
  Eighty-three subjects (66 with systolic heart failure and 17 healthy controls) underwent CMR, 2D echocardiography, and cardiopulmonary exercise testing for comparison of echocardiographic indices of RV function with CMR RVEF, 6-minute walk distance and VO(2 PEAK).
  
  
  RESULTS
  Speckle tracking strain RV strain exhibited the closest association with CMR RV ejection fraction. Indices of RV function demonstrated weak correlation with 6-minute walk distance, but basal RV strain rate by tissue velocity imaging had good correlation with VO(2 PEAK).
  
  
  CONCLUSIONS
  Strain by speckle tracking echocardiography and strain rate by tissue velocity imaging may offer complementary information in the evaluation of RV contractility and its functional effects.
authors.affiliation: Flinders Centre for Cardiovascular Magnetic Resonance Research (FCCMR), Flinders University of South Australia, Adelaide, Australia. darryl.leong@adelaide.edu.au
authors.forename: Darryl P
authors.initials: DP
authors.lastname: Leong
authors.forename: Suchi
authors.initials: S
authors.lastname: Grover
authors.forename: Payman
authors.initials: P
authors.lastname: Molaee
authors.forename: Adhiraj
authors.initials: A
authors.lastname: Chakrabarty
authors.forename: Mitra
authors.initials: M
authors.lastname: Shirazi
authors.forename: Yi H
authors.initials: YH
authors.lastname: Cheng
authors.forename: Amy
authors.initials: A
authors.lastname: Penhall
authors.forename: Rebecca
authors.initials: R
authors.lastname: Perry
authors.forename: Hugh
authors.initials: H
authors.lastname: Greville
authors.forename: Majo X
authors.initials: MX
authors.lastname: Joseph
authors.forename: Joseph B
authors.initials: JB
authors.lastname: Selvanayagam
mesh_terms: D004452:Echocardiography / Q000379:methods*; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006333:Heart Failure / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology*